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General NPI Number Information
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NPI Number | 1407396120
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Entity Type | Organization
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Legal Business Name | CHILD MENTAL HEALTH SOLUTIONS, LLC
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Dates
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Enumeration Date | 02/28/2017
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | 36 OLD KINGS HWY S
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City | DARIEN
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State | CT
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Zip | 06820-4552
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Country | US
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Telephone | 475-214-8233
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Fax |
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Provider Business Mailing Address
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Address Line | 14 BUENA VISTA ST
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City | STAMFORD
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State | CT
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Zip | 06907-2401
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAQUELINE SIMPSON-DUNNE
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Credential | APRN
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Telephone | 475-214-8233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 3260
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License Number State | CT
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