Provider Demographics
NPI:1225684590
Name:JOSHI, SHRUTI (MS, LPC)
Entity Type:Individual
Prefix:
First Name:SHRUTI
Middle Name:
Last Name:JOSHI
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:SHRUTI
Other - Middle Name:
Other - Last Name:YEDAVE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:75 WEST ST
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6528
Mailing Address - Country:US
Mailing Address - Phone:860-354-8556
Mailing Address - Fax:860-354-3975
Practice Address - Street 1:325 DANBURY RD
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-4344
Practice Address - Country:US
Practice Address - Phone:860-354-8556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-13
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT101YP2500X
NH2373101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional