| Renew Counseling Associates | |
|
8 Wakeman Rd Fairfield CT 06824-5120 | |
| (203) 255-5078 | |
| Not Available |
| Full Name | Renew Counseling Associates |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 8 Wakeman Rd, Fairfield, Connecticut |
| Authorized Official Name and Position | Duane Kellogg (DIRECTOR) |
| Authorized Official Contact | 2032555078 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Counseling Associates 8 Wakeman Rd Fairfield CT 06824-5120 Ph: (203) 255-5078 | Renew Counseling Associates 8 Wakeman Rd Fairfield CT 06824-5120 Ph: (203) 255-5078 |
| NPI Number | 1164652871 |
|---|---|
| Provider Enumeration Date | 07/16/2009 |
| Last Update Date | 02/19/2015 |
| Medicare PECOS PAC ID | 9133266109 |
|---|---|
| Medicare Enrollment ID | O20091023000126 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164652871 | NPI | - | NPPES |
| Provider Name | Melissa Elek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790010866 PECOS PAC ID: 8224160866 Enrollment ID: I20100719000195 |
| Provider Name | Maria Socci Mercado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730457128 PECOS PAC ID: 5698931970 Enrollment ID: I20120801000264 |
| Provider Name | Katherine Bothos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114254836 PECOS PAC ID: 6204197312 Enrollment ID: I20180307000748 |
| Provider Name | Jenna Wills |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942897350 PECOS PAC ID: 8022422799 Enrollment ID: I20210121001059 |
| Provider Name | Anisa K. Taliercio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962030858 PECOS PAC ID: 7113316621 Enrollment ID: I20211122001713 |
| Provider Name | Rae L. Legere-reardon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588196752 PECOS PAC ID: 5092105254 Enrollment ID: I20211201002361 |
| Provider Name | David Korver |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609591726 PECOS PAC ID: 5698118487 Enrollment ID: I20240208002720 |
| Provider Name | Abigail Davis Wolff-france |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1154831394 PECOS PAC ID: 5193163343 Enrollment ID: I20240405003109 |
| Provider Name | Lauren Osso |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891202214 PECOS PAC ID: 8325486277 Enrollment ID: I20240410003978 |
| Provider Name | Tamara Anne Tarrant |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1265045074 PECOS PAC ID: 4880032747 Enrollment ID: I20240411000139 |
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