Provider Demographics
NPI:1679558316
Name:PLANTEN, CHERYL ANN (LMFT,LADC)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:PLANTEN
Suffix:
Gender:F
Credentials:LMFT,LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 TOAS ST
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-5530
Mailing Address - Country:US
Mailing Address - Phone:203-573-7121
Mailing Address - Fax:203-573-7303
Practice Address - Street 1:88 GRANDVIEW AVE
Practice Address - Street 2:CHIL/ADOL
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2509
Practice Address - Country:US
Practice Address - Phone:203-573-7121
Practice Address - Fax:203-573-7303
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000259101YA0400X
DE000474106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist