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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