| Ridgefield Youth Service Bureau Inc | |
|
66 Prospect St Ridgefield CT 06877-4621 | |
| (203) 409-1760 | |
| Not Available |
| Full Name | Ridgefield Youth Service Bureau Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 66 Prospect St, Ridgefield, Connecticut |
| Authorized Official Name and Position | John Katz (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2034824019 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ridgefield Youth Service Bureau Inc 66 Prospect St Ridgefield CT 06877-4621 Ph: (203) 409-1760 | Ridgefield Youth Service Bureau Inc 66 Prospect St Ridgefield CT 06877-4621 Ph: (203) 409-1760 |
| NPI Number | 1881081024 |
|---|---|
| Provider Enumeration Date | 04/24/2015 |
| Last Update Date | 07/03/2024 |
| Certification Date | 07/03/2024 |
| Medicare PECOS PAC ID | 1658816723 |
|---|---|
| Medicare Enrollment ID | O20240712001961 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881081024 | NPI | - | NPPES |
| Provider Name | Nathan David Carpenter |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1881084945 PECOS PAC ID: 5294270369 Enrollment ID: I20240712002112 |
| Provider Name | Douglas Romney Barile |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1649555160 PECOS PAC ID: 1658810221 Enrollment ID: I20240827002729 |
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