Provider Demographics
NPI:1508187527
Name:ACTIVE COUNSELING, LLC
Entity Type:Organization
Organization Name:ACTIVE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDEIRA-SARAIVA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:203-644-3438
Mailing Address - Street 1:111 EAST AVENUE
Mailing Address - Street 2:SUITE 313
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851
Mailing Address - Country:US
Mailing Address - Phone:203-644-3438
Mailing Address - Fax:
Practice Address - Street 1:111 EAST AVE
Practice Address - Street 2:SUITE 313
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5014
Practice Address - Country:US
Practice Address - Phone:203-644-3438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1524251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health