Provider Demographics
NPI:1326773896
Name:TRUDEL, SIERRA MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:MARIE
Last Name:TRUDEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SIERRA
Other - Middle Name:MARIE
Other - Last Name:VARIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:62 SYLVAN AVE
Mailing Address - Street 2:
Mailing Address - City:UNIONVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06085-1169
Mailing Address - Country:US
Mailing Address - Phone:570-856-4521
Mailing Address - Fax:
Practice Address - Street 1:62 SYLVAN AVE
Practice Address - Street 2:
Practice Address - City:UNIONVILLE
Practice Address - State:CT
Practice Address - Zip Code:06085-1169
Practice Address - Country:US
Practice Address - Phone:570-856-4521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004850101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional