Provider Demographics
NPI:1518342781
Name:VANBERGEN, APRIL (MA, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:VANBERGEN
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:
Other - Last Name:VAN BERGEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:1275 POST RD STE A19
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6060
Mailing Address - Country:US
Mailing Address - Phone:203-900-7060
Mailing Address - Fax:800-587-9152
Practice Address - Street 1:1275 POST RD STE A19
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6060
Practice Address - Country:US
Practice Address - Phone:203-900-7060
Practice Address - Fax:800-587-9152
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YS0200X, 101YM0800X
CT003127101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health