Provider Demographics
NPI:1598133944
Name:COUNSELING & FAMILY THERAPY CENTER
Entity Type:Organization
Organization Name:COUNSELING & FAMILY THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRIERO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-908-3303
Mailing Address - Street 1:185 RONALD DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3604
Mailing Address - Country:US
Mailing Address - Phone:203-908-3303
Mailing Address - Fax:203-362-5802
Practice Address - Street 1:60 KATONA DR
Practice Address - Street 2:SUITE 22
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-3544
Practice Address - Country:US
Practice Address - Phone:203-908-3303
Practice Address - Fax:203-362-5802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000772106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004236239Medicaid