Healthcare Provider Details

I. General information

NPI: 1285721936
Provider Name (Legal Business Name): PATRICIA PARKER LEWIS LMFT LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 02/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 CEDAR ST
NEW BRITAIN CT
06052-1301
US

IV. Provider business mailing address

100 GRAND ST STE E119
NEW BRITAIN CT
06052-2016
US

V. Phone/Fax

Practice location:
  • Phone: 860-224-5804
  • Fax: 860-224-5752
Mailing address:
  • Phone: 860-224-5900
  • Fax: 860-224-5740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLADC000557
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number000778LMFT
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: