Provider Demographics
NPI:1154708857
Name:LALLY, CATARINA (LPC)
Entity type:Individual
Prefix:
First Name:CATARINA
Middle Name:
Last Name:LALLY
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:CATARINA
Other - Middle Name:
Other - Last Name:ANDRADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:12 ELEANOR RD
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:CT
Mailing Address - Zip Code:06483-3816
Mailing Address - Country:US
Mailing Address - Phone:203-895-5095
Mailing Address - Fax:
Practice Address - Street 1:51 N ELM ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1545
Practice Address - Country:US
Practice Address - Phone:203-574-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-01
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5064103T00000X
CT3066101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist