Provider Demographics
NPI:1407968282
Name:PONTBRIAND, GIUSEPPINA LISA (LPC, ATR)
Entity Type:Individual
Prefix:
First Name:GIUSEPPINA
Middle Name:LISA
Last Name:PONTBRIAND
Suffix:
Gender:F
Credentials:LPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-2419
Mailing Address - Country:US
Mailing Address - Phone:860-667-0088
Mailing Address - Fax:860-775-2400
Practice Address - Street 1:67 ONEIDA ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-2419
Practice Address - Country:US
Practice Address - Phone:860-667-0088
Practice Address - Fax:860-775-2400
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT001401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT240001401CT01OtherANTHEM
CT004257780Medicaid
CTZCN89660OtherAETNA