Healthcare Provider Details

I. General information

NPI: 1285583088
Provider Name (Legal Business Name): CONEFLOWER WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2026
Last Update Date: 01/26/2026
Certification Date: 01/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 STATE ST STE 401
BRIDGEPORT CT
06604-4806
US

IV. Provider business mailing address

177 STATE ST STE 401
BRIDGEPORT CT
06604-4806
US

V. Phone/Fax

Practice location:
  • Phone: 203-581-2992
  • Fax:
Mailing address:
  • Phone: 203-581-2992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. MARISSA EVE FERRAO
Title or Position: OWNER
Credential: LPC, ATR-P
Phone: 203-581-2992