Healthcare Provider Details

I. General information

NPI: 1649574799
Provider Name (Legal Business Name): THELMA MARIE EPPS LADC, CAC, ICADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2011
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 MAIN ST
HARTFORD CT
06106-1860
US

IV. Provider business mailing address

PO BOX 331271
WEST HARTFORD CT
06133-1271
US

V. Phone/Fax

Practice location:
  • Phone: 860-983-0246
  • Fax: 860-760-2018
Mailing address:
  • Phone: 860-983-0246
  • Fax: 860-760-2018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number000937
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6592
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: