Provider Demographics
NPI:1508283128
Name:MORENA, PAOLO (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:PAOLO
Middle Name:
Last Name:MORENA
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 DANBURY RD
Mailing Address - Street 2:SUITE D-2
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4142
Mailing Address - Country:US
Mailing Address - Phone:203-837-0055
Mailing Address - Fax:
Practice Address - Street 1:109 DANBURY RD
Practice Address - Street 2:SUITE D-2
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4142
Practice Address - Country:US
Practice Address - Phone:203-837-0055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT46.002852101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health