Healthcare Provider Details

I. General information

NPI: 1851706337
Provider Name (Legal Business Name): FRIEDRICH C MAURER III LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MR. FRITZ MAURER

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 MAIN ST
DANIELSON CT
06239-2816
US

IV. Provider business mailing address

245 MAIN ST
DANIELSON CT
06239-2816
US

V. Phone/Fax

Practice location:
  • Phone: 888-316-5221
  • Fax:
Mailing address:
  • Phone: 860-885-8374
  • Fax: 866-203-2138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number002401
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number002401
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: