Healthcare Provider Details

I. General information

NPI: 1083599799
Provider Name (Legal Business Name): JESSICA ANTOINETTE FIELDS LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 MAIN ST S STE B2
WOODBURY CT
06798-3738
US

IV. Provider business mailing address

50 SAW MILL RD UNIT 2102
DANBURY CT
06810-5143
US

V. Phone/Fax

Practice location:
  • Phone: 203-263-3175
  • Fax:
Mailing address:
  • Phone: 914-413-9030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8415
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: