MEDICARE: FAMILY AND CHILDREN'S AID, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor
2	1041C0700X	Clinical Social Worker
3	106H00000X	Marriage & Family Therapist
4	2084P0804X	Child & Adolescent Psychiatry Physician
5	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	0480	CT
6	261QM0850X	Adult Mental Health Clinic/Center
7	376J00000X	Homemaker	HCA.0000179
8	261QM0855X	Adolescent and Children Mental Health Clinic/Center	OPCC-20	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821059486
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY AND CHILDREN'S AID, INC.

Provider Business Mailing Address
First Line	:	77 WEST ST
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-6528
Country	:	US
Telephone Number	:	203-748-5689
Fax Number	:	203-790-8183

Provider Business Practice Location Address
First Line	:	80 WEST ST
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-6531
Country	:	US
Telephone Number	:	203-748-5689
Fax Number	:	203-790-8183

Authorized Official
Title or Position	:	EXECUTIVE/MEDICAL DIRECTOR
Name	:	DR. IRVIN R JENNINGS
Credential	:	M.D.
Telephone Number	:	203-748-5689

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	05/09/2024

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Directions to “FAMILY AND CHILDREN'S AID, INC. ” Practice Location

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