Provider Demographics
NPI:1891139671
Name:KUNTZ, LORI B (LMFT)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:B
Last Name:KUNTZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:B
Other - Last Name:TRIBUZIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O BOX 453
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06011
Mailing Address - Country:US
Mailing Address - Phone:860-977-7260
Mailing Address - Fax:203-879-4442
Practice Address - Street 1:246 WOLCOTT RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WOLCOTT
Practice Address - State:CT
Practice Address - Zip Code:06716
Practice Address - Country:US
Practice Address - Phone:203-879-4424
Practice Address - Fax:203-879-4442
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001113106H00000X
CT1113106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist