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Individual

SHANKAR PANWAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
K 11, 1783 MERIDEN WATERBURY TPKE, SOUTHINGTON, CT 06489
(203) 404-1010
(860) 426-2898
Mailing address
102 PEMBROKE RD, HAMDEN, CT 06514-2626
(203) 668-3554
(860) 426-2898

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
104100000X
Social Worker
Primary
1041C0700X
Clinical Social Worker

Other

Enumeration date
03/06/2020
Last updated
03/07/2020
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