Healthcare Provider Details

I. General information

NPI: 1770947780
Provider Name (Legal Business Name): PAOLO MORENA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2016
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
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: 800-942-6201
Mailing address:
  • Phone: 203-837-0055
  • Fax: 800-942-6201

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: PAOLO MORENA
Title or Position: OWNER, LPC
Credential: MS, LPC
Phone: 203-837-0055