Provider Demographics
NPI:1831148758
Name:SITLER, ELIZABETH B (MS LPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:B
Last Name:SITLER
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 AVALON PLACE
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109
Mailing Address - Country:US
Mailing Address - Phone:860-257-3595
Mailing Address - Fax:
Practice Address - Street 1:300 HEBRON AVE
Practice Address - Street 2:STE 217
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033
Practice Address - Country:US
Practice Address - Phone:860-659-2697
Practice Address - Fax:860-659-3468
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001022101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP3007020OtherOXFORD
CT2400014022CT01OtherANTHEM