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General NPI Number Information
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NPI Number | 1518486059
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Entity Type | Organization
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Legal Business Name | MEASURABLE PROGRESS THERAPY, LLC
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 100 WHITING ST # 409
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City | WINSTED
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State | CT
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Zip | 06098-1878
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Country | US
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Telephone | 203-598-4707
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Fax | 888-453-0519
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Provider Business Mailing Address
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Address Line | 192 CAMPVILLE RD
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City | NORTHFIELD
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State | CT
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Zip | 06778-2218
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Country | US
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Telephone | 203-598-4707
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Fax | 888-453-0519
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Authorized Official
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Title or Position | OWNER
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Name | MRS. NICOLE I MULHALL
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Credential | LCSW
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Telephone | 203-598-4707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 007064
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License Number State | CT
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