Provider Demographics
NPI:1588718951
Name:NEUWIRTH, SHARON L (LMFT)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:L
Last Name:NEUWIRTH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18 WILLIEB ST APT 6A
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-3090
Mailing Address - Country:US
Mailing Address - Phone:860-241-0317
Mailing Address - Fax:860-241-0327
Practice Address - Street 1:103 WOODLAND AVENUE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105
Practice Address - Country:US
Practice Address - Phone:860-241-0317
Practice Address - Fax:860-241-0327
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001822101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001822OtherLMFT