Provider Demographics
NPI:1285721936
Name:LEWIS, PATRICIA PARKER (LMFT LADC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:PARKER
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LMFT LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRAND ST STE E119
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-2016
Mailing Address - Country:US
Mailing Address - Phone:860-224-5900
Mailing Address - Fax:860-224-5740
Practice Address - Street 1:73 CEDAR ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1301
Practice Address - Country:US
Practice Address - Phone:860-224-5804
Practice Address - Fax:860-224-5752
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTLADC000557101Y00000X
CT000778LMFT106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor