Healthcare Provider Details

I. General information

NPI: 1255606661
Provider Name (Legal Business Name): MILISSA FLORES MS,HS-BCP, CAC,LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2012
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1549 FAIRFIELD AVE
BRIDGEPORT CT
06605-1935
US

IV. Provider business mailing address

419 WHALLEY AVE
NEW HAVEN CT
06511-3019
US

V. Phone/Fax

Practice location:
  • Phone: 203-366-6790
  • Fax:
Mailing address:
  • Phone: 203-285-6475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number001064
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number009949
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: