Provider Demographics
NPI:1447715297
Name:FAIRFIELD PSYCHOLOGICAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:FAIRFIELD PSYCHOLOGICAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-855-7566
Mailing Address - Street 1:325 FLAX HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854-2405
Mailing Address - Country:US
Mailing Address - Phone:203-855-7566
Mailing Address - Fax:
Practice Address - Street 1:325 FLAX HILL RD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-2405
Practice Address - Country:US
Practice Address - Phone:203-855-7566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty