Healthcare Provider Details

I. General information

NPI: 1386200749
Provider Name (Legal Business Name): FRANCIS BERARDI LADC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2019
Last Update Date: 05/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 MAIN ST STE 229
STRATFORD CT
06615-5839
US

IV. Provider business mailing address

1140 JAMES ST
STRATFORD CT
06614-4916
US

V. Phone/Fax

Practice location:
  • Phone: 203-529-1510
  • Fax: 954-278-7064
Mailing address:
  • Phone: 203-529-1510
  • Fax: 954-278-7064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. FRANCIS XAVIER BERARDI
Title or Position: OWNER
Credential: LADC
Phone: 203-529-1510