Provider Demographics
NPI:1922233220
Name:FINAN, LISA L (LADC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:L
Last Name:FINAN
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 FEDERAL RD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2418
Mailing Address - Country:US
Mailing Address - Phone:203-417-4986
Mailing Address - Fax:
Practice Address - Street 1:88 HEATHERWOOD DR
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-3957
Practice Address - Country:US
Practice Address - Phone:203-417-4986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-16
Last Update Date:2009-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000871101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)