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General NPI Number Information
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NPI Number | 1093882508
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Entity Type | Individual
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Provider Name | CAROL LYNN BERRAN LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 12/14/2011
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Provider Practice Location Address
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Address Line | 79 PAYNE RD
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City | BETHEL
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State | CT
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Zip | 06801-1264
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Country | US
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Telephone | 203-743-1150
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Fax | 203-743-1105
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Provider Business Mailing Address
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Address Line | 38 OLD RIDGEBURY RD
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City | DANBURY
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State | CT
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Zip | 06810-5128
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Country | US
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Telephone | 203-743-1150
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Fax | 203-743-1105
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 001092
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | SA-0215
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License Number State | CT
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