Provider Demographics
NPI:1881130631
Name:SJOGREN, INGER (MASTERS, LPC)
Entity type:Individual
Prefix:
First Name:INGER
Middle Name:
Last Name:SJOGREN
Suffix:
Gender:F
Credentials:MASTERS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 GRAENEST RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-2929
Mailing Address - Country:US
Mailing Address - Phone:203-247-7563
Mailing Address - Fax:
Practice Address - Street 1:225 MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3216
Practice Address - Country:US
Practice Address - Phone:203-493-6557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
102L00000X
CT3530101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst