Provider Demographics
NPI:1659826725
Name:ALYSIA L BROWN, LMFT, LLC
Entity Type:Organization
Organization Name:ALYSIA L BROWN, LMFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:ALYSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-716-7048
Mailing Address - Street 1:1720 ELLINGTON ROAD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-2815
Mailing Address - Country:US
Mailing Address - Phone:860-281-7221
Mailing Address - Fax:
Practice Address - Street 1:1720 ELLINGTON RD
Practice Address - Street 2:SUITE B
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2742
Practice Address - Country:US
Practice Address - Phone:860-281-7221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2017-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001571106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty