Provider Demographics
NPI:1093839797
Name:KRONICK, SONDRA (LMFT,LADC)
Entity Type:Individual
Prefix:MS
First Name:SONDRA
Middle Name:
Last Name:KRONICK
Suffix:
Gender:F
Credentials:LMFT,LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 BRUNING RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06057-2535
Mailing Address - Country:US
Mailing Address - Phone:869-309-6115
Mailing Address - Fax:860-738-2549
Practice Address - Street 1:12 N MAIN ST STE 108
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-1932
Practice Address - Country:US
Practice Address - Phone:860-561-8727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000468101YA0400X
CT000413106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT195547OtherMHN
CT125156OtherVALUE OPTIONS
CT300000468CT02OtherANTHEM BLUE CROSS-LADC
CT410000413CT08OtherANTHEM BLUE CROSS-THOMAST
CT11243094OtherCAQH
CT195547OtherHEALTHNET
CT41000413CT09OtherANTHEM BLUE CROSS
CT779454OtherMAGELLAN