Healthcare Provider Details

I. General information

NPI: 1609770296
Provider Name (Legal Business Name): ERIN MARY MACLEAN LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 DAWSON AVE UNIT 1
WEST HAVEN CT
06516-6408
US

IV. Provider business mailing address

54 DAWSON AVE UNIT 1
WEST HAVEN CT
06516-6408
US

V. Phone/Fax

Practice location:
  • Phone: 860-391-1304
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7947
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: