Provider Demographics
NPI:1629252788
Name:CODDINGTON, LILA L (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:LILA
Middle Name:L
Last Name:CODDINGTON
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 ROBBINS STREET
Mailing Address - Street 2:WATERBURY HOSPITAL - CRISIS CENTER
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06721
Mailing Address - Country:US
Mailing Address - Phone:203-573-6103
Mailing Address - Fax:203-573-7578
Practice Address - Street 1:64 ROBBINS STREET
Practice Address - Street 2:WATERBURY HOSPITAL - CRISIS CENTER
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06721
Practice Address - Country:US
Practice Address - Phone:203-573-6103
Practice Address - Fax:203-573-7578
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001226106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist