Healthcare Provider Details

I. General information

NPI: 1497234421
Provider Name (Legal Business Name): FRANCIS XAVIER BERARDI MS, LADC, ICAADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: FRANK XAVIER BERARDI MS, LADC, ICAADC

II. Dates (important events)

Enumeration Date: 08/10/2018
Last Update Date: 08/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 BYINGTON PL
NORWALK CT
06850-3309
US

IV. Provider business mailing address

1140 JAMES ST
STRATFORD CT
06614-4916
US

V. Phone/Fax

Practice location:
  • Phone: 203-866-2541
  • Fax: 203-854-5682
Mailing address:
  • Phone: 954-295-4050
  • Fax: 954-278-7064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number000027
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: