NPIMap

Organization Active NPI

Mental Health Services of Fairfield, LLC

  • Professional Counselor
  • Fairfield, CT
National Provider Identifier
1881081354
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1906 Issued in CT
Legal business name
MENTAL HEALTH SERVICES OF FAIRFIELD, LLC
Practice address
39 Sherman CT
2ND Floor
Fairfield, CT 06824-5852
Phone
(203) 998-5721
NPI assigned
Apr 22, 2015
Last updated
Apr 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Authorized official

Name
Amanda D. Romaniello, LPCNPI 1942596507
Title
Sole Proprietor
Phone
(203) 988-5721

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1906 CT Primary

Addresses

Primary practice location

39 Sherman CT
2ND Floor
Fairfield, CT 06824-5852

Mailing address

39 Sherman CT
2ND Floor
Fairfield, CT 06824-5852

National Provider Directory

National Provider Directory

Locations

39 Sherman Ct
Fl 2
Fairfield, CT 06824
Phone (203) 216-1716

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1881081354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 SHERMAN CT",
            "address_2": "2ND FLOOR",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 SHERMAN CT",
            "address_2": "2ND FLOOR",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245852",
            "telephone_number": "203-998-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH SERVICES OF FAIRFIELD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "ROMANIELLO",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "203-988-5721",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "1906",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 22, 2015; 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.