MEDICARE: MARIA TEREZA SHVARTSMAN MA, LADC, CCDP

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	000632	CT

General Provider Information

NPI Number	:	1598806044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA TEREZA SHVARTSMAN MA, LADC, CCDP

Provider Business Mailing Address
First Line	:	153 GREENWOOD AVE
Second Line	:	SUITE #6
City	:	BETHEL
State	:	CT
Zip	:	06801-2527
Country	:	US
Telephone Number	:	203-743-4112
Fax Number	:	203-743-6464

Provider Business Practice Location Address
First Line	:	153 GREENWOOD AVE
Second Line	:	SUITE #6
City	:	BETHEL
State	:	CT
Zip	:	06801-2527
Country	:	US
Telephone Number	:	203-743-4112
Fax Number	:	203-743-6464

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

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	07/08/2007

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