Provider Demographics
NPI:1386708899
Name:SCHNEIDERMAN, JOAN ELLEN (MS, LMFT)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:ELLEN
Last Name:SCHNEIDERMAN
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 WELLES ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-4205
Mailing Address - Country:US
Mailing Address - Phone:860-633-9967
Mailing Address - Fax:860-633-5013
Practice Address - Street 1:49 WELLES ST
Practice Address - Street 2:SUITE 210
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4205
Practice Address - Country:US
Practice Address - Phone:860-633-9967
Practice Address - Fax:860-633-5013
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000762106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist