Provider Demographics
NPI:1114394418
Name:LORIN, EMILY (MA, LPC, RYT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:LORIN
Suffix:
Gender:F
Credentials:MA, LPC, RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 ALDEN AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-2109
Mailing Address - Country:US
Mailing Address - Phone:678-235-4194
Mailing Address - Fax:
Practice Address - Street 1:2446 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3233
Practice Address - Country:US
Practice Address - Phone:203-298-9005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0004258101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional