| Fairfield Counseling Group Llc | |
|
60 Katona Dr Suite 25 Fairfield CT 06824-3544 | |
| (203) 275-8555 | |
| (203) 612-9830 |
| Full Name | Fairfield Counseling Group Llc |
|---|---|
| Speciality | Social Worker |
| Location | 60 Katona Dr, 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 |
|---|---|
| Fairfield Counseling Group Llc 60 Katona Dr Suite 25 Fairfield CT 06824-3544 Ph: (203) 275-8555 | Fairfield Counseling Group Llc 60 Katona Dr Suite 25 Fairfield CT 06824-3544 Ph: (203) 275-8555 |
| NPI Number | 1750633285 |
|---|---|
| Provider Enumeration Date | 10/08/2012 |
| Last Update Date | 03/25/2014 |
| Medicare PECOS PAC ID | 0345494936 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669528774 PECOS PAC ID: 7719979236 Enrollment ID: I20040402000177 |
| Provider Name | Nellie E Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679742282 PECOS PAC ID: 7416026927 Enrollment ID: I20080522000548 |
| Provider Name | Angelica Fontanez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710175161 PECOS PAC ID: 5597919183 Enrollment ID: I20130207000169 |
| Provider Name | Deirdre Ekholdt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841562337 PECOS PAC ID: 5294998944 Enrollment ID: I20151218001127 |
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