Suzanne Ciaramella, PSYD

Individual provider Active NPI Clinical Psychologist · Mansfield Center, CT

NPI 1154476778 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154476778
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
002467 (CT)
Practice address
6 Storrs Rd
Suite #3
Mansfield Center, CT 06250
Phone
(860) 423-6572
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
002467CTMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 002467 CT Yes

Addresses

Primary practice location

6 Storrs Rd
Suite #3
Mansfield Center, CT 06250

Mailing address

67 Scotland Rd
Windham, CT 06280-1219
Phone (860) 916-4253

Other identifiers

IdentifierTypeStateIssuer
060002467CT01OtherCTANTHEM BCBS
345897OtherCTMHN

Other providers in Mansfield Center, CT

All providers in Mansfield Center, CT · Clinical Psychologist in Connecticut

Sources for this page

Verify at the official NPI Registry.