Provider Demographics
NPI:1124815998
Name:MILLET, THERESA MARGARET (LMFTA)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:MARGARET
Last Name:MILLET
Suffix:
Gender:
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 DEEPWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-1799
Mailing Address - Country:US
Mailing Address - Phone:860-510-3435
Mailing Address - Fax:
Practice Address - Street 1:6 WOODLAND RD UNIT 3B
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2685
Practice Address - Country:US
Practice Address - Phone:860-510-3435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3225106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist