Provider Demographics
NPI:1922179209
Name:SKLENER, SHARLA (LADC)
Entity Type:Individual
Prefix:
First Name:SHARLA
Middle Name:
Last Name:SKLENER
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 OXFORD DR
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06118-2643
Mailing Address - Country:US
Mailing Address - Phone:860-568-7879
Mailing Address - Fax:
Practice Address - Street 1:995 DAY HILL RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-1722
Practice Address - Country:US
Practice Address - Phone:860-731-5522
Practice Address - Fax:860-863-8074
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000682101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)