Kara Fairchild, LMFT

Individual provider Active NPI Mental Health Counselor · Middletown, CT

NPI 1497278675 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1497278675
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
1930 (CT)
Practice address
79 Mill St
Middletown, CT 06457-4468
Phone
(860) 258-6060
NPI assigned
Jul 19, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Well Life Therapy, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1930 CT Yes

Addresses

Primary practice location

79 Mill St
Middletown, CT 06457-4468

Mailing address

79 Mill St
Middletown, CT 06457-4468
Phone (860) 258-6060

Other identifiers

IdentifierTypeStateIssuer
1972964898OtherCTWELL LIFE THERAPY, LLC

Other providers in Middletown, CT

All providers in Middletown, CT · Mental Health Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.