Healthcare Provider Details

I. General information

NPI: 1164333886
Provider Name (Legal Business Name): NICOLE JOY SPERANO LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 MAIN ST
FARMINGTON CT
06032-2985
US

IV. Provider business mailing address

84 CANCELLARO DR
WOLCOTT CT
06716-1203
US

V. Phone/Fax

Practice location:
  • Phone: 860-919-1304
  • Fax:
Mailing address:
  • Phone: 860-919-1304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6487
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: