# SOUTHERN CT CHRISTIAN NETWORK

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Shoreline Christian Counseling
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033239249
- **Authorized official:** MRS. ULARI DIKE (OFFICE MANAGER)
- **Authorized official phone:** (203) 318-0700

## Contact information

- **Practice address:** 145 DURHAM RD, MAILBOX 7, MADISON, CT 06443-2674
- **Practice address phone:** (203) 318-0070
- **Practice address fax:** (206) 339-8205
- **Mailing address:** 145 DURHAM RD, MAILBOX 7, MADISON, CT 06443-2674
- **Mailing address phone:** (203) 318-0070
- **Mailing address fax:** (206) 339-8205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | 001460 | CT | — |
| 1041C0700X | Clinical Social Worker | 002876 | CT | — |
| 1041C0700X | Clinical Social Worker | 004809 | CT | — |
| 2084F0202X | Forensic Psychiatry Physician | 039301 | CT | Yes |

## Other

- **Enumeration date:** 03/30/2007
- **Last updated:** 10/14/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004257269 | — | CT |
| 05 | — | 004257277 | — | CT |
| 05 | — | 004257532 | — | CT |
| 01 | — | 307875 | HEALTHNET-MHN | CT |