Provider Demographics
NPI:1225111255
Name:OTRIN, DENA MARIE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DENA
Middle Name:MARIE
Last Name:OTRIN
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 1:55 LOOKOUT RD
Mailing Address - Street 2:PO BOX 48
Mailing Address - City:WESTBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06498
Mailing Address - Country:US
Mailing Address - Phone:860-227-4411
Mailing Address - Fax:
Practice Address - Street 1:CONNECTIONS COUNSELING AND WELLNESS CENTER LLC
Practice Address - Street 2:163 BOSTON POST RD
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385
Practice Address - Country:US
Practice Address - Phone:860-444-8774
Practice Address - Fax:860-444-8776
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001294101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional