Paine Center for Neurofeedback LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

007720 Issued in CT

Legal business name

PAINE CENTER FOR NEUROFEEDBACK LLC

Practice address

140 Sherman St
Fairfield, CT 06824-5849

Phone

(203) 823-5109

NPI assigned

Sep 27, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tara Paine, LCSW

Title

Owner

Phone

(203) 823-5109

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506470400000",
    "number": "1104335694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 COLONIAL HEIGHTS RD",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064734100",
            "telephone_number": "203-823-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SHERMAN ST",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245849",
            "telephone_number": "203-823-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAINE CENTER FOR NEUROFEEDBACK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-27",
        "last_updated": "2017-09-27",
        "status": "A",
        "authorized_official_last_name": "PAINE",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-823-5109",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadine BJ Padowicz, LCSW
• Christina Wendy Padron-Cotto, SLP
• Arsenio Paez, DPT
• Jessica R Page, LADC
• Pain & Spine Specialists of Connecticut, LLC
• Daniel Palevo, A.T.C
• Kaitlyn Nicole Palevo, MS, ATC, LAT
• Laura Palmer
• Jorge David Palomino Vargas, MD
• Anna Pankratov, MD

• Clinical Social Worker in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.