Provider Demographics
NPI:1477239598
Name:ARNOLD, LISA SUE (LMFT, LADC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:SUE
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:LMFT, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 POND VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06795-3152
Mailing Address - Country:US
Mailing Address - Phone:203-982-2826
Mailing Address - Fax:
Practice Address - Street 1:21 LOCUST AVE STE 2A
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-4735
Practice Address - Country:US
Practice Address - Phone:203-982-2826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3087106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist