| Faithwell Counseling And Services, Llc. | |
|
1204 Main St Ste 512 Branford CT 06405-3787 | |
| (678) 314-4695 | |
| (203) 481-7634 |
| Full Name | Faithwell Counseling And Services, Llc. |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1204 Main St Ste 512, Branford, Connecticut |
| Authorized Official Name and Position | Mireille Gaines (CLINICIAN) |
| Authorized Official Contact | 6783144695 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Faithwell Counseling And Services, Llc. 1204 Main St Ste 512 Branford CT 06405-3787 Ph: (678) 314-4695 | Faithwell Counseling And Services, Llc. 1204 Main St Ste 512 Branford CT 06405-3787 Ph: (678) 314-4695 |
| NPI Number | 1154901973 |
|---|---|
| Provider Enumeration Date | 04/14/2021 |
| Last Update Date | 06/08/2021 |
| Certification Date | 06/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154901973 | NPI | - | NPPES |
| 1154901973 | Medicaid | CT | |
| 1861040065 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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