Provider Demographics
NPI:1689076630
Name:SENIEL LUCIEN LLC
Entity Type:Organization
Organization Name:SENIEL LUCIEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:SENIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCIEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, PHD
Authorized Official - Phone:860-526-8109
Mailing Address - Street 1:805 FARMINGTON AVE.
Mailing Address - Street 2:#5
Mailing Address - City:W. HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1670
Mailing Address - Country:US
Mailing Address - Phone:860-526-8109
Mailing Address - Fax:860-526-8109
Practice Address - Street 1:805 FARMINGTON AVE.
Practice Address - Street 2:#5
Practice Address - City:W. HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-1670
Practice Address - Country:US
Practice Address - Phone:860-526-8109
Practice Address - Fax:860-526-8109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000751102L00000X
CT0063411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty