Provider Demographics
NPI:1841056413
Name:FREDERICK L MORIN LPC
Entity type:Organization
Organization Name:FREDERICK L MORIN LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-522-8241
Mailing Address - Street 1:554 LIBERTY HWY STE 6
Mailing Address - Street 2:
Mailing Address - City:PUTNAM
Mailing Address - State:CT
Mailing Address - Zip Code:06260-2728
Mailing Address - Country:US
Mailing Address - Phone:860-522-8241
Mailing Address - Fax:
Practice Address - Street 1:554 LIBERTY HWY STE 6
Practice Address - Street 2:
Practice Address - City:PUTNAM
Practice Address - State:CT
Practice Address - Zip Code:06260-2728
Practice Address - Country:US
Practice Address - Phone:860-522-8241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty