Provider Demographics
NPI:1164589701
Name:DUSZA, DOREEN (LPC)
Entity Type:Individual
Prefix:MS
First Name:DOREEN
Middle Name:
Last Name:DUSZA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N MAIN ST
Mailing Address - Street 2:SUITE 318
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-1968
Mailing Address - Country:US
Mailing Address - Phone:860-989-6932
Mailing Address - Fax:860-240-7078
Practice Address - Street 1:10 N MAIN ST
Practice Address - Street 2:SUITE 318
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-1968
Practice Address - Country:US
Practice Address - Phone:860-989-6932
Practice Address - Fax:860-240-7078
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000373101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional