Individual
MR. CARL SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
97 SOUTH ST STE 105, WEST HARTFORD, CT 06110-1964
(860) 461-0504
Mailing address
97 SOUTH ST STE 105, WEST HARTFORD, CT 06110-1964
(860) 461-0504
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
000245
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
CT
Enumeration date
04/05/2022
Last updated
04/05/2022
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