MEDICARE: SPRINGTIDE CHILD DEVELOPMENT, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	235Z00000X	Speech-Language Pathologist
2	225X00000X	Occupational Therapist
3	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1396383568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRINGTIDE CHILD DEVELOPMENT, INC.

Provider Business Mailing Address
First Line	:	PO BOX 740
Second Line	:
City	:	MONROE
State	:	CT
Zip	:	06468-0740
Country	:	US
Telephone Number	:	203-880-5495
Fax Number	:	203-816-5495

Provider Business Practice Location Address
First Line	:	126 MONROE TPKE
Second Line	:
City	:	TRUMBULL
State	:	CT
Zip	:	06611-1300
Country	:	US
Telephone Number	:	781-492-4991
Fax Number	:	855-217-6179

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	MONICA HAMMEL
Credential	:
Telephone Number	:	765-461-5410

Provider Enumeration Date	:	12/18/2019
Last Update Date	:	12/14/2021

Similar Medicare Providers

1134076094 — CAROLINE FERNANDES
Practice Location Address:

126 MONROE TPKE STE 210
TRUMBULL, CT
06611-1300

Practice Phone: 203-800-3596
Practice Fax:

1518102631 — DR. LUBNA KHAN D.M.D., MDS
Practice Location Address:

126 MONROE TPKE
TRUMBULL, CT
06611-1300

Practice Phone: 203-590-3222
Practice Fax: 203-590-3273

1144653403 — TRUMBULL ORTHODONICS
Practice Location Address:

126 MONROE TPKE
TRUMBULL, CT
06611-1300

Practice Phone: 860-670-1905
Practice Fax:

1639540941 — LJH ENTERPRISES LLC
Practice Location Address:

126 MONROE TPKE , 2ND FLOOR
TRUMBULL, CT
06611-1300

Practice Phone: 860-930-4590
Practice Fax:

1790328458 — ASTRID TORIBIO
Practice Location Address:

126 MONROE TPKE # 210
TRUMBULL, CT
06611-1300

Practice Phone: 347-781-8080
Practice Fax:

1659910107 — EILEEN MARKHAM BARRECA DPT
Practice Location Address:

126 MONROE TPKE STE 210
TRUMBULL, CT
06611-1300

Practice Phone: 781-492-4991
Practice Fax:

Directions to “SPRINGTIDE CHILD DEVELOPMENT, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.