Healthcare Provider Details

I. General information

NPI: 1144573395
Provider Name (Legal Business Name): SUSAN LEIGH BAUERFELD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 HARBOR VIEW AVE
NORWALK CT
06854-4821
US

IV. Provider business mailing address

4 HARBOR VIEW AVE
NORWALK CT
06854-4821
US

V. Phone/Fax

Practice location:
  • Phone: 203-216-3751
  • Fax:
Mailing address:
  • Phone: 203-216-3751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number003108
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: