Provider Demographics
NPI:1386928919
Name:CZAKO, SHARON MICHELE (MS)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:MICHELE
Last Name:CZAKO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:MICHELE
Other - Last Name:DAHLMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:74 EAST STREET
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062
Mailing Address - Country:US
Mailing Address - Phone:860-793-4420
Mailing Address - Fax:
Practice Address - Street 1:74 EAST STREET
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062
Practice Address - Country:US
Practice Address - Phone:860-793-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health