Provider Demographics
NPI:1508190521
Name:GUERRERA, CHRISTINE ANN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ANN
Last Name:GUERRERA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ANN
Other - Last Name:CALANDRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:35 HERITAGE ROAD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468
Mailing Address - Country:US
Mailing Address - Phone:203-260-9353
Mailing Address - Fax:203-445-1624
Practice Address - Street 1:388 MAIN STREET
Practice Address - Street 2:SUITE 1B
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468
Practice Address - Country:US
Practice Address - Phone:203-260-9353
Practice Address - Fax:203-445-1624
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001024106H00000X
CT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008057896Medicaid