Healthcare Provider Details

I. General information

NPI: 1417170879
Provider Name (Legal Business Name): FAMILY & CHILDREN'S AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 MOTT AVE 4TH FLOOR
NORWALK CT
06850-3330
US

IV. Provider business mailing address

9 MOTT AVE 4TH FLOOR
NORWALK CT
06850-3330
US

V. Phone/Fax

Practice location:
  • Phone: 203-855-8765
  • Fax: 203-838-3325
Mailing address:
  • Phone: 203-855-8765
  • Fax: 203-838-3325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberC-0127
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberOPCC-39
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ROBERT F CASHEL
Title or Position: PRESIDENT & CEO
Credential: LCSW
Phone: 203-855-8765