Provider Demographics
NPI:1629691621
Name:LUCE, EMBERLEIGH LYN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:EMBERLEIGH
Middle Name:LYN
Last Name:LUCE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:EMBERLEIGH
Other - Middle Name:LYN
Other - Last Name:LUCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:10 FORT HILL RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-4757
Mailing Address - Country:US
Mailing Address - Phone:860-961-3413
Mailing Address - Fax:
Practice Address - Street 1:4 FORT HILL RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-4723
Practice Address - Country:US
Practice Address - Phone:860-961-3413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-26
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2131106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist