Provider Demographics
NPI:1376184713
Name:GARLAND, LORRAINE (LPCA)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:GARLAND
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 TAYLOR LN
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-6348
Mailing Address - Country:US
Mailing Address - Phone:203-254-1803
Mailing Address - Fax:
Practice Address - Street 1:2960 POST RD STE 3B2
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:CT
Practice Address - Zip Code:06890-1268
Practice Address - Country:US
Practice Address - Phone:203-307-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health