Provider Demographics
NPI:1609051069
Name:BLATCHLEY, LANCIA (LMFT)
Entity Type:Individual
Prefix:
First Name:LANCIA
Middle Name:
Last Name:BLATCHLEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4133 WHITNEY AVE
Mailing Address - Street 2:SUITE A 13
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-1432
Mailing Address - Country:US
Mailing Address - Phone:203-444-7587
Mailing Address - Fax:203-230-1727
Practice Address - Street 1:4133 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-1432
Practice Address - Country:US
Practice Address - Phone:203-444-7587
Practice Address - Fax:203-230-1727
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001232106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist