Healthcare Provider Details

I. General information

NPI: 1184343436
Provider Name (Legal Business Name): NURJHAN SPENCE LMFT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 NEW BRITAIN RD STE C
BERLIN CT
06037-5306
US

IV. Provider business mailing address

370 HIGH ST APT 104
NEW BRITAIN CT
06051-5113
US

V. Phone/Fax

Practice location:
  • Phone: 860-698-4339
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: NURJHAN STRACHAN-SPENCE
Title or Position: MARRIAGE AND FAMILY THERAPIST
Credential: LMFT
Phone: 860-698-4339