Bergeron, Cody Cooper
Bergeron, Cody Cooper is an sole proprietor health care provider with primary practice located at 425 Kings Hwy E , Fairfield CT 06825-4852. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bergeron, Cody Cooper can be contacted via phone (203) 307-0119.Contact Information
Primary practice address
425 Kings Hwy E
Fairfield CT 06825-4852
Phone: (203) 307-0119
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 8934 | Connecticut |
Profile Details
| NPI number | 1649606096 |
|---|---|
| LBN Legal business name | Bergeron, Cody Cooper |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 17th, 2013 |
| Last updated | Dec 6th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649606096 | NPPES |
| Connecticut | Other | 8934 | LICENSED CLINICAL SOCIAL WORKER |
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