Provider Demographics
NPI:1114020344
Name:LACERENZA, ARLENE N (LMFT)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:N
Last Name:LACERENZA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 RIVER ST
Mailing Address - Street 2:SUITE 11
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3346
Mailing Address - Country:US
Mailing Address - Phone:203-306-0220
Mailing Address - Fax:203-907-3628
Practice Address - Street 1:53 RIVER ST
Practice Address - Street 2:SUITE 11
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3346
Practice Address - Country:US
Practice Address - Phone:203-306-0220
Practice Address - Fax:203-907-3628
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001114106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT333392OtherMHN
CT410001114CT01OtherBLUE CROSS
CT7718836OtherAETNA
CT410001114CT02OtherBLUE CROSS
CTP3625938OtherOXFORD