Provider Demographics
NPI:1336531219
Name:DESIREE SCIME LMFT LADC LLC
Entity type:Organization
Organization Name:DESIREE SCIME LMFT LADC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCIME
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT,LADC
Authorized Official - Phone:203-668-1926
Mailing Address - Street 1:387 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3651
Mailing Address - Country:US
Mailing Address - Phone:203-668-1926
Mailing Address - Fax:203-583-3927
Practice Address - Street 1:27 SIEMON COMPANY DR STE 110W
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795-2654
Practice Address - Country:US
Practice Address - Phone:203-668-1926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001437106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1199429OtherCAQH
CT402319OtherBEACON HEALTH-VOPTIONS
CT008056849Medicaid
CT410001437CT01OtherANTHEM BCBS OF CT
CTPENDINGOtherANTHEM BCBS OF CT
CTPENDINGOtherOPTUM BEHAVIORAL HEALTH