Healthcare Provider Details

I. General information

NPI: 1508283128
Provider Name (Legal Business Name): PAOLO MORENA MS, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2014
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 DANBURY RD OFC K
RIDGEFIELD CT
06877-4147
US

IV. Provider business mailing address

34 MIDROCKS RD
RIDGEFIELD CT
06877-2120
US

V. Phone/Fax

Practice location:
  • Phone: 203-837-0055
  • Fax:
Mailing address:
  • Phone: 203-837-0055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number46.002852
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: