Provider Demographics
NPI:1518104983
Name:MCGUANE, COLLEEN SHARON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:SHARON
Last Name:MCGUANE
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 1:13 PARK ST
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:MA
Mailing Address - Zip Code:01562-1813
Mailing Address - Country:US
Mailing Address - Phone:508-885-0027
Mailing Address - Fax:
Practice Address - Street 1:433 S MAIN ST STE 327
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-2816
Practice Address - Country:US
Practice Address - Phone:860-676-9350
Practice Address - Fax:774-253-2055
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CT003828103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health