Provider Demographics
NPI:1679710164
Name:DAIGLE, KAREN A (LADC, LPC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:DAIGLE
Suffix:
Gender:F
Credentials:LADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 NEW HARWINTON RD
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-5932
Mailing Address - Country:US
Mailing Address - Phone:860-309-7262
Mailing Address - Fax:860-485-9375
Practice Address - Street 1:913 NEW HARWINTON RD
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-5932
Practice Address - Country:US
Practice Address - Phone:860-309-7262
Practice Address - Fax:860-485-9375
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT101Y00000X
CT782101YA0400X
CT3168101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional