Provider Demographics
NPI:1548537996
Name:MIELE, CHARLEEN K (LPC)
Entity type:Individual
Prefix:MRS
First Name:CHARLEEN
Middle Name:K
Last Name:MIELE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 MARKET SQ
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-2927
Mailing Address - Country:US
Mailing Address - Phone:860-614-8382
Mailing Address - Fax:860-561-5394
Practice Address - Street 1:171 MARKET SQ
Practice Address - Street 2:SUITE 102
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2927
Practice Address - Country:US
Practice Address - Phone:860-614-8382
Practice Address - Fax:860-561-5394
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11YM0800X101YM0800X
CT002593101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health