Provider Demographics
NPI:1205250586
Name:DEBRA L. TOMASELLI, LMFT, LLC
Entity type:Organization
Organization Name:DEBRA L. TOMASELLI, LMFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TOMASELLI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-645-1677
Mailing Address - Street 1:2296 MAIN STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615
Mailing Address - Country:US
Mailing Address - Phone:203-645-1677
Mailing Address - Fax:203-377-4946
Practice Address - Street 1:2296 MAIN STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615
Practice Address - Country:US
Practice Address - Phone:203-645-1677
Practice Address - Fax:203-377-4946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-07
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001558106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty