Provider Demographics
NPI:1275038960
Name:SPIVEY, LORINDA B (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LORINDA
Middle Name:B
Last Name:SPIVEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 RASPBERRY LN
Mailing Address - Street 2:
Mailing Address - City:ELLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06029-2516
Mailing Address - Country:US
Mailing Address - Phone:860-878-4426
Mailing Address - Fax:
Practice Address - Street 1:100 WEST RD STE 3
Practice Address - Street 2:
Practice Address - City:ELLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06029-3798
Practice Address - Country:US
Practice Address - Phone:860-454-0520
Practice Address - Fax:860-454-8469
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0058331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical