Provider Demographics
NPI:1891278552
Name:BARRETT, LISA ANNE (LPC/ATR)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANNE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:LPC/ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 AMBASSADOR DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-2465
Mailing Address - Country:US
Mailing Address - Phone:860-539-6027
Mailing Address - Fax:860-539-6027
Practice Address - Street 1:44 S MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06088-1702
Practice Address - Country:US
Practice Address - Phone:860-254-5127
Practice Address - Fax:860-254-5254
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT46.003541101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional