Fairfield Counseling Group LLC

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

FAIRFIELD COUNSELING GROUP LLC

Practice address

35 Kings Hwy E
Fairfield, CT 06825-4873

Phone

(203) 948-4126

Fax

(203) 612-9830

NPI assigned

Oct 8, 2012

Organization subpart

No

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

Authorized official

Name

Angelica Fontanez, MSWNPI 1710175161

Title

LCSW

Phone

(917) 543-2209

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

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

• Angelica Fontanez, L.C.S.W.

  • Clinical Social Worker
  • Fairfield, CT
  • NPI 1710175161
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1750633285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DAHLIA LN",
            "city": "WEST REDDING",
            "state": "CT",
            "postal_code": "068961421",
            "telephone_number": "203-948-4126",
            "fax_number": "203-612-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 KINGS HWY E",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068254873",
            "telephone_number": "203-948-4126",
            "fax_number": "203-612-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFIELD COUNSELING GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "FONTANEZ",
        "authorized_official_first_name": "ANGELICA",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "917-543-2209",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.