McKenzie Tavella LLC
Counselor, Professional in Fairfield, CT. Organization (NPI-2).
NPI number1609784644
StatusActive
Last updated in NPPESAug 31, 2026
Details
- NPI
- 1609784644
- Entity type
- Organization (NPI-2)
- Legal business name
- McKenzie Tavella LLC
- Organization subpart
- No
- Enumeration date
- Aug 31, 2026
- Certification date
- Aug 31, 2026
- Last updated
- Aug 31, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
45 Sherman StFairfield, CT 06824-5874
Phone 203-984-4838
Mailing address
45 Sherman StFairfield, CT 06824-5874
Authorized official
McKenzie M Tavella
Owner / Lpc
2039844838
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