Provider Demographics
NPI:1326202409
Name:COSUMANO, SONYA M (LMFT, MED)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:M
Last Name:COSUMANO
Suffix:
Gender:F
Credentials:LMFT, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 CHAPEL RD STE E
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-4157
Mailing Address - Country:US
Mailing Address - Phone:860-436-4390
Mailing Address - Fax:860-436-6448
Practice Address - Street 1:435 CHAPEL RD STE E
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-4157
Practice Address - Country:US
Practice Address - Phone:860-436-4390
Practice Address - Fax:860-436-6448
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001265106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist