Provider Demographics
NPI:1407077860
Name:DUPUIS, SHEILA RENEE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:RENEE
Last Name:DUPUIS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41C NEW LONDON TPKE
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-4206
Mailing Address - Country:US
Mailing Address - Phone:860-659-0579
Mailing Address - Fax:860-659-0570
Practice Address - Street 1:41C NEW LONDON TPKE
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4206
Practice Address - Country:US
Practice Address - Phone:860-659-0579
Practice Address - Fax:860-659-0570
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002620103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT357673OtherMHN INS
CT004250461OtherEDS-CT BHP INS
CT060002620CT01OtherANTHEM INS.
CT61-28606OtherUBH INS
CTP3671225OtherOXFORD INS