=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841562527
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SUZANNE REIDY ARNONE MED, LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2012
-----------------------------------------------------
Last Update Date | 01/27/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 33 BERNHARD RD
-----------------------------------------------------
City | NORTH HAVEN
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06473
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-470-5353
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 69 TAUNTON LAKE RD
-----------------------------------------------------
City | NEWTOWN
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06470-1447
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-426-4851
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 000985
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------