Provider Demographics
NPI:1194923730
Name:LANG, TRICIA MALINOWSKI (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:TRICIA
Middle Name:MALINOWSKI
Last Name:LANG
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:MS
Other - First Name:TRICIA
Other - Middle Name:
Other - Last Name:MALINOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:950 SLATER RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053
Mailing Address - Country:US
Mailing Address - Phone:860-761-6694
Mailing Address - Fax:860-761-6692
Practice Address - Street 1:950 SLATER RD.
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053
Practice Address - Country:US
Practice Address - Phone:860-761-6694
Practice Address - Fax:860-761-6692
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001888101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health