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Organization
LIFEBRIDGE COMMUNITY SERVICES, INC
Active
Organization
LIFEBRIDGE COMMUNITY SERVICES, INC
Active
Other names
Fairfield Counseling Services, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK FARIAS (CHIEF FINANCIAL & HR OFFICER)
(203) 368-4291
Entity
Organization
Contact information
Practice address
125 PENFIELD ROAD, FAIRFIELD, CT 06824-6639
(203) 255-5777
(203) 259-9673
Mailing address
125 PENFIELD RD., FAIRFIELD, CT 06824-6639
(203) 255-5777
(203) 259-9673
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0334
CT
106H00000X
Marriage & Family Therapist
0400
CT
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
0400
CT
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004069985
—
CT
05
—
004083606
—
CT
Enumeration date
10/05/2005
Last updated
11/18/2020
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