Healthcare Provider Details

I. General information

NPI: 1851460687
Provider Name (Legal Business Name): SUSAN B. SIRLIN M.A., L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

488 MAIN AVE
NORWALK CT
06851-1008
US

IV. Provider business mailing address

9 SILVER BROOK RD
WESTPORT CT
06880-1522
US

V. Phone/Fax

Practice location:
  • Phone: 203-324-3167
  • Fax:
Mailing address:
  • Phone: 203-226-4541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number000573
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000573
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: