Provider Demographics
NPI:1346405289
Name:WARING, SHERYLL ANN (LPC LADC)
Entity Type:Individual
Prefix:MRS
First Name:SHERYLL
Middle Name:ANN
Last Name:WARING
Suffix:
Gender:F
Credentials:LPC LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 GRISWOLD STREET
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033
Mailing Address - Country:US
Mailing Address - Phone:860-933-5532
Mailing Address - Fax:860-942-8274
Practice Address - Street 1:352 GRISWOLD STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033
Practice Address - Country:US
Practice Address - Phone:860-933-5532
Practice Address - Fax:860-942-8274
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000791101YA0400X
CT000695101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1346405289Medicaid