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General NPI Number Information
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NPI Number | 1689302523
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Entity Type | Individual
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Provider Name | STEPHANIE KAREN WATKINS LPCA
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Gender | Female
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Dates
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Enumeration Date | 08/09/2022
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 66 CEDAR ST STE 204
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City | NEWINGTON
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State | CT
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Zip | 06111-2655
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Country | US
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Telephone | 860-665-0200
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Fax | 860-540-1609
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Provider Business Mailing Address
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Address Line | 66 CEDAR ST STE 204
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City | NEWINGTON
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State | CT
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Zip | 06111-2655
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Country | US
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Telephone | 860-716-9592
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Fax | 860-540-1609
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5436
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License Number State | CT
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