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

LicenseStateTypeSpecialty
4620CTMDSurgical Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Woodbury, CT

All providers in Woodbury, CT · Professional Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.