OrganizationActive
Therapy Blis
NPI 1750120580 · Clinical Social Worker · Fairfield, CT
Provider details
- NPI number
- 1750120580
- Entity type
- Organization
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Chaneil Beckford, Ceo(203) 418-0767
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1506 Post Rd
Fairfield, CT 06824-5916
Phone: (203) 418-0767
Street-level locationGet directions
Mailing address
2389 Main St Ste 100
Glastonbury, CT 06033-4617
Registry dates
- Enumerated
- 2024-05-21
- Last updated
- 2024-05-21
- Certified
- 2024-05-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.