Healthcare Provider Details

I. General information

NPI: 1336075456
Provider Name (Legal Business Name): ZACHARY RICHARD BARNES LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4699 MAIN ST STE 210
BRIDGEPORT CT
06606-1830
US

IV. Provider business mailing address

1 BATES CT APT 102
NORWALK CT
06854-5915
US

V. Phone/Fax

Practice location:
  • Phone: 203-208-3940
  • Fax: 203-717-5153
Mailing address:
  • Phone: 310-489-0542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number003906
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: