Healthcare Provider Details

I. General information

NPI: 1104959261
Provider Name (Legal Business Name): DANBURY YOUTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 09/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 WEST STREET
DANBURY CT
06810-6529
US

IV. Provider business mailing address

91 WEST STREET
DANBURY CT
06810-6529
US

V. Phone/Fax

Practice location:
  • Phone: 203-748-2936
  • Fax: 203-797-8568
Mailing address:
  • Phone: 203-748-2936
  • Fax: 203-797-8568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH ARCONTI
Title or Position: CLINICAL DIRECTOR
Credential: MS, LPC
Phone: 203-748-2936