Provider Demographics
NPI:1114175452
Name:LLOYD, CARISSA (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:CARISSA
Middle Name:
Last Name:LLOYD
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 NORTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062-1534
Mailing Address - Country:US
Mailing Address - Phone:860-793-4408
Mailing Address - Fax:860-793-4460
Practice Address - Street 1:91 NORTHWEST DR
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-1534
Practice Address - Country:US
Practice Address - Phone:860-793-4408
Practice Address - Fax:860-793-4460
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001377106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist