Provider Demographics
NPI:1053572610
Name:PROSSER, CAROLE BABETTE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:CAROLE
Middle Name:BABETTE
Last Name:PROSSER
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 1:741 BOSTON POST RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2714
Mailing Address - Country:US
Mailing Address - Phone:203-458-2480
Mailing Address - Fax:203-458-2479
Practice Address - Street 1:741 BOSTON POST RD
Practice Address - Street 2:SUITE 102
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2714
Practice Address - Country:US
Practice Address - Phone:203-458-2480
Practice Address - Fax:203-458-2479
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001229106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist