Healthcare Provider Details

I. General information

NPI: 1871379891
Provider Name (Legal Business Name): LAGOM LIFESTYLE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

486 S MAIN ST
THOMASTON CT
06787-1844
US

IV. Provider business mailing address

60 LEXINGTON AVE
TORRINGTON CT
06790-3430
US

V. Phone/Fax

Practice location:
  • Phone: 860-387-5587
  • Fax:
Mailing address:
  • Phone: 860-387-5587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: BRANDY M SELLITTO-TAYLOR
Title or Position: OWNER
Credential: LPC
Phone: 860-387-5587