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General NPI Number Information
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NPI Number | 1811068893
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Entity Type | Organization
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Legal Business Name | CHRISTIAN COUNSELING CENTER OF GREATER DANBURY INC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 2 OLD NEW MILFORD ROAD LANDMARK OFFICE BUILDING SUITE 2A
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City | BROOKFIELD
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State | CT
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Zip | 06804-2426
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Country | US
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Telephone | 203-775-3282
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Fax | 203-775-3478
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Provider Business Mailing Address
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Address Line | 2 OLD NEW MILFORD ROAD LANDMARK OFFICE BUILDING SUITE 2A
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City | BROOKFIELD
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State | CT
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Zip | 06804-2426
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Country | US
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Telephone | 203-775-3282
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Fax | 203-775-3478
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Authorized Official
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Title or Position | ASSISTANT DIRECTOR
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Name | MRS. CHERYL ANN FUSCO
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Credential | RN MHCNS
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Telephone | 203-775-3282
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 006329
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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