Provider Demographics
NPI:1033770656
Name:SANSONE, ANNE (MS, NCC)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:SANSONE
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 W JOHNSON AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-4505
Mailing Address - Country:US
Mailing Address - Phone:860-358-0188
Mailing Address - Fax:
Practice Address - Street 1:609 W JOHNSON AVE STE 310
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-4502
Practice Address - Country:US
Practice Address - Phone:860-358-0188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4706OtherLICENSED PROFESSIONAL COUNSELOR
312053OtherNBCC