Fairfield Counseling Group Llc | |
35 Kings Hwy E Fairfield CT 06825-4873 | |
(203) 948-4126 | |
(203) 612-9830 |
Full Name | Fairfield Counseling Group Llc |
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Speciality | Social Worker |
Location | 35 Kings Hwy E, Fairfield, Connecticut |
Authorized Official Name and Position | Angelica Fontanez (LCSW) |
Authorized Official Contact | 9175432209 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Fairfield Counseling Group Llc 7 Dahlia Ln West Redding CT 06896-1421 Ph: (203) 948-4126 | Fairfield Counseling Group Llc 35 Kings Hwy E Fairfield CT 06825-4873 Ph: (203) 948-4126 |
NPI Number | 1750633285 |
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Provider Enumeration Date | 10/08/2012 |
Last Update Date | 08/01/2024 |
Certification Date | 08/01/2024 |
Medicare PECOS PAC ID | 0345494936 |
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Medicare Enrollment ID | O20130207000128 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750633285 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Secondary |
104100000X | Social Worker | (* (Not Available)) | Primary |
Provider Name | Elba I Crespo |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1669528774 PECOS PAC ID: 7719979236 Enrollment ID: I20040402000177 |
Provider Name | Nellie E Rivera |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1679742282 PECOS PAC ID: 7416026927 Enrollment ID: I20080522000548 |
Provider Name | Angelica Fontanez |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1710175161 PECOS PAC ID: 5597919183 Enrollment ID: I20130207000169 |
Provider Name | Deirdre Ekholdt |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1841562337 PECOS PAC ID: 5294998944 Enrollment ID: I20151218001127 |
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