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General NPI Number Information
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NPI Number | 1710480132
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Entity Type | Organization
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Legal Business Name | CONTEMPORARY CARE COUNSELING
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Dates
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Enumeration Date | 03/12/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 81 HOLLY HILL LN
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City | GREENWICH
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State | CT
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Zip | 06830-6071
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Country | US
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Telephone | 203-321-5063
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Fax | 203-769-1313
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Provider Business Mailing Address
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Address Line | 84 HOSPITAL AVE
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City | DANBURY
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State | CT
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Zip | 06810-6047
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Country | US
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Telephone | 203-792-0400
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Fax | 203-792-0400
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Authorized Official
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Title or Position | CEO
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Name | DR. TRIQUE PERERA
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Credential | MD
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Telephone | 203-952-2919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 039232
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License Number State | CT
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