Provider Demographics
NPI:1225782170
Name:CONTI, CELINE (LPC)
Entity Type:Individual
Prefix:
First Name:CELINE
Middle Name:
Last Name:CONTI
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 1:601 NORWICH AVE UNIT 102
Mailing Address - Street 2:
Mailing Address - City:TAFTVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06380-2804
Mailing Address - Country:US
Mailing Address - Phone:860-878-0359
Mailing Address - Fax:
Practice Address - Street 1:47 WATER ST
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-2573
Practice Address - Country:US
Practice Address - Phone:860-878-0359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005299101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional