Provider Demographics
NPI:1346466729
Name:LUCIEN, SENIEL (LCSW)
Entity Type:Individual
Prefix:
First Name:SENIEL
Middle Name:
Last Name:LUCIEN
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 1:19 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06412-1302
Mailing Address - Country:US
Mailing Address - Phone:860-526-8109
Mailing Address - Fax:860-526-8109
Practice Address - Street 1:19 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:CT
Practice Address - Zip Code:06412-1302
Practice Address - Country:US
Practice Address - Phone:860-526-8109
Practice Address - Fax:860-526-8109
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000751102L00000X
CT006341103TC0700X, 1041C0700X
NYPO3333311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008045870Medicaid