Faithwell Counseling and Services, LLC.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

FAITHWELL COUNSELING AND SERVICES, LLC.

Practice address

1204 Main St Ste 512
Branford, CT 06405-3787

Phone

(678) 314-4695

Fax

(203) 481-7634

NPI assigned

Apr 14, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mireille Gaines, LPCNPI 1861040065

Title

Clinician

Phone

(678) 314-4695

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mireille Gaines, LPC

  • Counselor
  • Branford, CT
  • NPI 1861040065
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1154901973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 MAIN ST STE 512",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053787",
            "telephone_number": "678-314-4695",
            "fax_number": "203-481-7634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 MAIN ST STE 512",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053787",
            "telephone_number": "678-314-4695",
            "fax_number": "203-481-7634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITHWELL COUNSELING AND SERVICES, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "GAINES",
        "authorized_official_first_name": "MIREILLE",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "678-314-4695",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154901973",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861040065",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Branford, CT
• Providers in Branford, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.