Provider Demographics
NPI:1932588019
Name:MORIN, FREDERICK L (LPC)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:L
Last Name:MORIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:860-890-9456
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:860-890-9456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-22
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3638101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional