Healthcare Provider Details

I. General information

NPI: 1134038912
Provider Name (Legal Business Name): PEYTON MAYZEL LPC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

350 SILAS DEANE HWY STE 303
WETHERSFIELD CT
06109-1700
US

IV. Provider business mailing address

12 DRUMMOND DR APT K
ROCKY HILL CT
06067-3322
US

V. Phone/Fax

Practice location:
  • Phone: 860-501-9488
  • Fax:
Mailing address:
  • Phone: 860-878-5696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: PEYTON MAYZEL
Title or Position: OWNER
Credential: LPC
Phone: 860-878-5696