NPIMap

Organization Active NPI

Fairfield County Counseling

  • Mental Health Counselor
  • Fairfield, CT
National Provider Identifier
1700314606
Registry record updated May 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FAIRFIELD COUNTY COUNSELING
Practice address
60 Katona Dr Ste 22
Fairfield, CT 06824-3544
Phone
(203) 605-2571
NPI assigned
May 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2017

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

Authorized official

Name
Ashley Boland
Title
Licensed Professional Counselor
Phone
(203) 605-2571

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

60 Katona Dr Ste 22
Fairfield, CT 06824-3544

Mailing address

54 Andrews Ave
Milford, CT 06460-5816

Other identifiers 3

IdentifierTypeStateIssuer
1154708857MedicaidCT
1184088700MedicaidCT
1427408079MedicaidCT

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495497600000",
    "number": "1700314606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 ANDREWS AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064605816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 KATONA DR STE 22",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068243544",
            "telephone_number": "203-605-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFIELD COUNTY COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-23",
        "last_updated": "2017-05-23",
        "status": "A",
        "authorized_official_last_name": "BOLAND",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "203-605-2571"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154708857",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184088700",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427408079",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; 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.