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General NPI Number Information
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NPI Number | 1578922290
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Entity Type | Organization
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Legal Business Name | IFC COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 02/23/2016
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Last Update Date | 02/23/2016
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Provider Practice Location Address
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Address Line | 2 POMPERAUG OFFICE PARK SUITE 206-C
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City | SOUTHBURY
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State | CT
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Zip | 06488-2288
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Country | US
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Telephone | 203-814-0747
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Fax |
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Provider Business Mailing Address
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Address Line | 30 HANOVER RD
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City | NEWTOWN
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State | CT
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Zip | 06470-1326
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VICTORIA NUNGESSER
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Credential | LCSW
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Telephone | 203-814-0747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 008464
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License Number State | CT
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