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NPI Code Detail

MEDICARE: SHARI FAYE FANELLI MS, LPC, ATR

MEDICARE: SHARI FAYE FANELLI MS, LPC, ATR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor002004CT

General Provider Information

NPI Number : 1689948887
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARI FAYE FANELLI MS, LPC, ATR
Provider Business Mailing Address
First Line : 144 SYLVAN KNOLL RD
Second Line :
City : STAMFORD
State : CT
Zip : 06902-5355
Country : US
Telephone Number : 201-446-8677
Fax Number :
Provider Business Practice Location Address
First Line : 103 W BROAD ST
Second Line :
City : STAMFORD
State : CT
Zip : 06902-3713
Country : US
Telephone Number : 203-517-3368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2012
Last Update Date : 03/06/2012

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