Provider Demographics
NPI:1215348800
Name:CHILD DEVELOPMENT PARTNERS, LLC
Entity type:Organization
Organization Name:CHILD DEVELOPMENT PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:GIURLEO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:978-501-2833
Mailing Address - Street 1:36 LAKE WARREN DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01460-1506
Mailing Address - Country:US
Mailing Address - Phone:978-501-2833
Mailing Address - Fax:
Practice Address - Street 1:809 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-3900
Practice Address - Country:US
Practice Address - Phone:978-501-2833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7759103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty