Healthcare Provider Details

I. General information

NPI: 1891615746
Provider Name (Legal Business Name): SUSAN LALIBERTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 RUSS ST STE 204
HARTFORD CT
06106-1523
US

IV. Provider business mailing address

52 FOWLER LN
EAST HARTFORD CT
06118-3025
US

V. Phone/Fax

Practice location:
  • Phone: 860-281-2461
  • Fax:
Mailing address:
  • Phone: 860-281-2461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: