MEDICARE: DR. COLLEEN SHARON MCGUANE PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	103TC0700X	Clinical Psychologist	003828	CT

General Provider Information

NPI Number	:	1518104983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLLEEN SHARON MCGUANE PSY.D.

Provider Business Mailing Address
First Line	:	13 PARK ST
Second Line	:
City	:	SPENCER
State	:	MA
Zip	:	01562-1813
Country	:	US
Telephone Number	:	508-885-0027
Fax Number	:

Provider Business Practice Location Address
First Line	:	433 S MAIN ST STE 327
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06110-2816
Country	:	US
Telephone Number	:	860-676-9350
Fax Number	:	774-253-2055

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2009
Last Update Date	:	08/27/2019

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