Provider Demographics
NPI:1750399176
Name:CAROLINO, SHERRI (LCSW, LADC)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:CAROLINO
Suffix:
Gender:F
Credentials:LCSW, LADC
Other - Prefix:
Other - First Name:SHERRI
Other - Middle Name:
Other - Last Name:MENGUAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-2310
Mailing Address - Country:US
Mailing Address - Phone:203-597-1935
Mailing Address - Fax:203-597-8711
Practice Address - Street 1:141 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-2310
Practice Address - Country:US
Practice Address - Phone:203-597-1935
Practice Address - Fax:203-597-8711
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0057571041C0700X
CT000767101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004236338Medicaid
CT008050379Medicaid
CT800003903Medicare ID - Type Unspecified