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Organization

FAIRFIELD COUNTY COUNSELING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ASHLEY BOLAND (LICENSED PROFESSIONAL COUNSELOR)
(203) 605-2571
Entity
Organization

Contact information

Practice address
60 KATONA DR STE 22, FAIRFIELD, CT 06824-3544
(203) 605-2571
Mailing address
54 ANDREWS AVE, MILFORD, CT 06460-5816

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1154708857
CT
05
1184088700
CT
05
1427408079
CT
Enumeration date
05/23/2017
Last updated
05/23/2017
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