Provider Demographics
NPI:1649322801
Name:CHULAK, DARLENE (LMFT)
Entity type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:
Last Name:CHULAK
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 1:140 CAPTAIN THOMAS BLVD, STE 116
Mailing Address - Street 2:
Mailing Address - City:WESTHAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-5981
Mailing Address - Country:US
Mailing Address - Phone:203-691-8640
Mailing Address - Fax:203-877-3109
Practice Address - Street 1:140 CAPTAIN THOMAS BLVD, STE 116
Practice Address - Street 2:
Practice Address - City:WESTHAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-5981
Practice Address - Country:US
Practice Address - Phone:203-691-8640
Practice Address - Fax:203-877-3109
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000194106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P2748720OtherOXFORD HEALTH
12770900OtherMEGELLAN
410000194CT01OtherANTHEM BC BS
072367OtherVOWE OPTIONS
6260648OtherUNITED BEHAVIORAL
079992OtherMHNI HEALTHNET