Provider Demographics
NPI:1568553840
Name:RAGUSA, CHRISTINE A (LMFT RD)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:A
Last Name:RAGUSA
Suffix:
Gender:F
Credentials:LMFT RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 WILLIAMSBURG ROAD
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:CT
Mailing Address - Zip Code:06447
Mailing Address - Country:US
Mailing Address - Phone:860-295-0138
Mailing Address - Fax:860-295-0022
Practice Address - Street 1:381 HUBBARD STREET
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033
Practice Address - Country:US
Practice Address - Phone:860-734-0002
Practice Address - Fax:860-295-0022
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000922106H00000X
CT000385133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT410000922CT01OtherANTHEM BLUE CROSS & BLUE
CT270000385CT01OtherANTHEM BLUE CROSS & BLUE