Provider Demographics
NPI:1194928515
Name:WERGELES, NANCY K (MS,MFT)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:K
Last Name:WERGELES
Suffix:
Gender:F
Credentials:MS,MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 FANTON HILL RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06883-2407
Mailing Address - Country:US
Mailing Address - Phone:203-227-2048
Mailing Address - Fax:
Practice Address - Street 1:49 JOHN ST
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:CT
Practice Address - Zip Code:06890-1436
Practice Address - Country:US
Practice Address - Phone:203-307-3030
Practice Address - Fax:203-255-7486
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001208106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist