Provider Demographics
NPI:1689241499
Name:KRAUSS, LISA JILL (MA,LPC,NCC,CMC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:JILL
Last Name:KRAUSS
Suffix:
Gender:F
Credentials:MA,LPC,NCC,CMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274A HERITAGE VLG
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-1738
Mailing Address - Country:US
Mailing Address - Phone:203-258-2640
Mailing Address - Fax:203-643-2270
Practice Address - Street 1:274A HERITAGE VLG
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-1738
Practice Address - Country:US
Practice Address - Phone:203-258-2640
Practice Address - Fax:203-643-2270
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional