Provider Demographics
NPI:1093414377
Name:MANSFIELD, CHARLOTTE (MFT)
Entity Type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:
Last Name:MANSFIELD
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 NEWBURY ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06114-2234
Mailing Address - Country:US
Mailing Address - Phone:860-965-0489
Mailing Address - Fax:
Practice Address - Street 1:642 HILLIARD ST STE 1310
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-2700
Practice Address - Country:US
Practice Address - Phone:860-965-0489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist