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General NPI Number Information
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NPI Number | 1659431518
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Entity Type | Organization
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Legal Business Name | THE CHILD AND FAMILY GUIDANCE CENTER, INC.
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 12/23/2014
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Provider Practice Location Address
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Address Line | 180 FAIRFIELD AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06604-4252
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Country | US
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Telephone | 203-394-6529
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Fax | 203-394-6534
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Provider Business Mailing Address
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Address Line | 180 FAIRFIELD AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06604-4252
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Country | US
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Telephone | 203-394-6529
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Fax | 203-394-6534
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | DR. L. PHILIP GUZMAN
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Credential | PH.D
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Telephone | 203-394-6529
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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