Organization
CB COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CODY BERGERON LCSW (LICENSED CLINICAL SOCIAL WORKER)
(203) 307-0119
Entity
Organization
Contact information
Practice address
425 KINGS HWY E, FAIRFIELD, CT 06825-4852
(203) 307-0119
Mailing address
516 WOODRIDGE AVE, FAIRFIELD, CT 06825-2577
(203) 247-9039
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8934
LCSW
CT
Enumeration date
12/06/2021
Last updated
12/06/2021
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