Individual
MS. SARA ELLEN COUSINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5 CALKINSTOWN RD, SHARON, CT 06069
(860) 480-8660
(860) 364-5766
Mailing address
PO BOX 832, SHARON, CT 06069
(860) 480-8660
(860) 364-5766
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
004963
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140004963CT01
ANTHEM
CT
01
—
37550
MVP
CT
01
—
37550
MVP
NY
Enumeration date
08/31/2006
Last updated
07/08/2007
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