Provider Demographics
NPI:1457136749
Name:LITCHFIELD HILLS INTEGRATIVE THERAPY
Entity type:Organization
Organization Name:LITCHFIELD HILLS INTEGRATIVE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SADIE
Authorized Official - Middle Name:MACLEAN
Authorized Official - Last Name:LUKOS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-560-9749
Mailing Address - Street 1:18 WILLOW LANE
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:CT
Mailing Address - Zip Code:06763
Mailing Address - Country:US
Mailing Address - Phone:203-560-9749
Mailing Address - Fax:
Practice Address - Street 1:29 ORTON LANE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798
Practice Address - Country:US
Practice Address - Phone:203-560-9749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty