Healthcare Provider Details

I. General information

NPI: 1356261937
Provider Name (Legal Business Name): LINDA LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 MAIN ST FL 13
HARTFORD CT
06103-2703
US

IV. Provider business mailing address

650 NEW BRITAIN AVE
HARTFORD CT
06106-4035
US

V. Phone/Fax

Practice location:
  • Phone: 203-800-9778
  • Fax: 203-841-1240
Mailing address:
  • Phone: 203-800-9778
  • Fax: 203-841-1240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number3900
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: