Provider Demographics
NPI:1073399838
Name:LEFEVRE, JOHN THOMAS (LPCA)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:THOMAS
Last Name:LEFEVRE
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 HEBRON AVE
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-5000
Mailing Address - Country:US
Mailing Address - Phone:860-777-6433
Mailing Address - Fax:
Practice Address - Street 1:703 HEBRON AVE
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-5000
Practice Address - Country:US
Practice Address - Phone:860-777-6433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health