| Live Free Therapy Llc | |
|
433 Meadow St Fairfield CT 06824-5372 | |
| (203) 913-3560 | |
| Not Available |
| Full Name | Live Free Therapy Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 433 Meadow St, Fairfield, Connecticut |
| Authorized Official Name and Position | Diana Kral (OWNER) |
| Authorized Official Contact | 2039133560 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Free Therapy Llc 433 Meadow St Fairfield CT 06824-5372 Ph: (203) 913-3560 | Live Free Therapy Llc 433 Meadow St Fairfield CT 06824-5372 Ph: (203) 913-3560 |
| NPI Number | 1174947915 |
|---|---|
| Provider Enumeration Date | 02/14/2014 |
| Last Update Date | 10/31/2023 |
| Certification Date | 10/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174947915 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 000979 (Connecticut) | Secondary |
| 101YP2500X | Counselor - Professional | 002020 (Connecticut) | Primary |
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