Individual
HEATHER K MAZARAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
141 FRANKLIN ST, STAMFORD, CT 06901-1014
(203) 602-4441
(203) 602-7782
Mailing address
350 FAIRFIELD AVE, SUITE 701, BRIDGEPORT, CT 06604-6014
(203) 335-5225
(203) 336-2851
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
007902
CT
101YM0800X
Mental Health Counselor
007902
CT
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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