Provider Demographics
NPI:1356366538
Name:CHARTIER, CELESTE R (LPC)
Entity type:Individual
Prefix:MS
First Name:CELESTE
Middle Name:R
Last Name:CHARTIER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 FIVE MILE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:PUTNAM
Mailing Address - State:CT
Mailing Address - Zip Code:06260-3106
Mailing Address - Country:US
Mailing Address - Phone:860-963-0465
Mailing Address - Fax:
Practice Address - Street 1:1007 NORTH MAIN ST.
Practice Address - Street 2:
Practice Address - City:DAYVILLE
Practice Address - State:CT
Practice Address - Zip Code:06241
Practice Address - Country:US
Practice Address - Phone:860-564-6100
Practice Address - Fax:860-564-6110
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000372101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000372OtherCT LICENSE NUMBER