Provider Demographics
NPI:1457542045
Name:CANADA, MARGARET F (MA,NCC,LPC)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:F
Last Name:CANADA
Suffix:
Gender:F
Credentials:MA,NCC,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 W MAIN ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-4501
Mailing Address - Country:US
Mailing Address - Phone:203-355-1238
Mailing Address - Fax:203-322-6879
Practice Address - Street 1:2001 W MAIN ST
Practice Address - Street 2:SUITE 140
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-4501
Practice Address - Country:US
Practice Address - Phone:203-355-1238
Practice Address - Fax:203-322-6879
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001220101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional