Basic Information
| Provider Information | |||||||||
| NPI: | 1285721936 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEWIS | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | PARKER | ||||||||
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| Credential: | LMFT LADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 GRAND ST STE E119 | ||||||||
| Address2: | |||||||||
| City: | NEW BRITAIN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060522016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602245900 | ||||||||
| FaxNumber: | 8602245740 | ||||||||
| Practice Location | |||||||||
| Address1: | 73 CEDAR ST | ||||||||
| Address2: | |||||||||
| City: | NEW BRITAIN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060521301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602245804 | ||||||||
| FaxNumber: | 8602245752 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2006 | ||||||||
| LastUpdateDate: | 02/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | LADC000557 | CT | N | Behavioral Health & Social Service Providers | Counselor | 106H00000X | 000778LMFT | CT | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.