Healthcare Provider Details

I. General information

NPI: 1083522312
Provider Name (Legal Business Name): ANAISIA NICOLE LINDSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 MAIN ST
WINDSOR LOCKS CT
06096-1919
US

IV. Provider business mailing address

21 GRAY ST FL 1
HARTFORD CT
06105-4002
US

V. Phone/Fax

Practice location:
  • Phone: 860-288-4458
  • Fax:
Mailing address:
  • Phone: 860-837-4396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9847
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: