Provider Demographics
NPI:1538491907
Name:CIARLELLI, ANDREA MARIE (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:MARIE
Last Name:CIARLELLI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 HIGHLAND AVE BLDG A
Mailing Address - Street 2:SUITE 6
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-2525
Mailing Address - Country:US
Mailing Address - Phone:203-651-9308
Mailing Address - Fax:
Practice Address - Street 1:408 HIGHLAND AVE BLDG A
Practice Address - Street 2:SUITE 6
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2525
Practice Address - Country:US
Practice Address - Phone:203-651-9308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001243106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist