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NPI Code Detail

MEDICARE: LR PSYCHOTHERAPY WELLNESS LLC

MEDICARE: LR PSYCHOTHERAPY WELLNESS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1811845258
Entity Type Code : Organization
Provider Name (Legal Business Name) : LR PSYCHOTHERAPY WELLNESS LLC
Provider Business Mailing Address
First Line : 314 NEW BRITAIN RD STE C
Second Line :
City : BERLIN
State : CT
Zip : 06037-5306
Country : US
Telephone Number : 860-385-4897
Fax Number : 860-385-4897
Provider Business Practice Location Address
First Line : 314 NEW BRITAIN RD STE C
Second Line :
City : BERLIN
State : CT
Zip : 06037-5306
Country : US
Telephone Number : 860-385-4897
Fax Number : 860-385-4897
Authorized Official
Title or Position : MARRIAGE AND FAMILY THERAPIST
Name : LISSETTE RAMOS
Credential : LMFT
Telephone Number : 860-385-4897
Provider Enumeration Date : 03/20/2026
Last Update Date : 03/20/2026

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Directions to “LR PSYCHOTHERAPY WELLNESS LLC ” Practice Location

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