Provider Demographics
NPI:1124738521
Name:PAPPALARDO, STEPHEN (PHD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:PAPPALARDO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-1968
Mailing Address - Country:US
Mailing Address - Phone:860-519-5227
Mailing Address - Fax:
Practice Address - Street 1:10 N MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-1968
Practice Address - Country:US
Practice Address - Phone:860-519-5227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4313103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical