Healthcare Provider Details

I. General information

NPI: 1598806044
Provider Name (Legal Business Name): MARIA TEREZA SHVARTSMAN MA, LADC, CCDP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 GREENWOOD AVE SUITE #6
BETHEL CT
06801-2527
US

IV. Provider business mailing address

153 GREENWOOD AVE SUITE #6
BETHEL CT
06801-2527
US

V. Phone/Fax

Practice location:
  • Phone: 203-743-4112
  • Fax: 203-743-6464
Mailing address:
  • Phone: 203-743-4112
  • Fax: 203-743-6464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number000632
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: