| Ada Therapy, Ll | |
|
333 Bennett St Fairfield CT 06825-1375 | |
| (203) 540-5186 | |
| Not Available |
| Full Name | Ada Therapy, Ll |
|---|---|
| Speciality | Counselor - Professional |
| Location | 333 Bennett St, Fairfield, Connecticut |
| Authorized Official Name and Position | Michael Weiss (CLINICAL PSYCHOLOGIST AND DIRECTOR) |
| Authorized Official Contact | 2035405186 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ada Therapy, Ll 333 Bennett St Fairfield CT 06825-1375 Ph: (203) 540-5186 | Ada Therapy, Ll 333 Bennett St Fairfield CT 06825-1375 Ph: (203) 540-5186 |
| NPI Number | 1104203546 |
|---|---|
| Provider Enumeration Date | 05/06/2015 |
| Last Update Date | 05/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104203546 | NPI | - | NPPES |
| 1083052468 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 002750 (Connecticut) | Primary |
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