Provider Demographics
NPI:1700372042
Name:OFGANG, CORINNE E (LPC)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:E
Last Name:OFGANG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 PINE HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06812-2209
Mailing Address - Country:US
Mailing Address - Phone:203-770-2065
Mailing Address - Fax:
Practice Address - Street 1:57 NORTH ST STE 323
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5628
Practice Address - Country:US
Practice Address - Phone:203-770-2065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3437101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional