Michael Faiella
Individual provider Active NPI Professional Counselor · Woodbury, CT
NPI 1326779554 · NPPES record last updated Jun 20, 2022
Key facts
- NPI
- 1326779554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 4620 (CT)
- Practice address
- 670 Main St S Ste B2
Woodbury, CT 06798-3738 - Phone
- (203) 263-3175
- NPI assigned
- Jun 20, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4620 | CT | MD | Surgical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4620 | CT | Yes |
Addresses
Primary practice location
670 Main St S Ste B2
Woodbury, CT 06798-3738
Mailing address
81 Howard Ave
Ansonia, CT 06401-2209
Phone (203) 906-7471
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.