Leslie Mallimson, LPC
Individual provider Active NPI Professional Counselor · Centerbrook, CT
NPI 1992877922 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992877922
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- CT000274CT (CT)
- Practice address
- 68 Main St
Centerbrook, CT 06409 - Phone
- (860) 767-2266
- Fax
- (860) 767-5067
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CT000274CT | CT | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CT000274CT | CT | Yes |
Addresses
Primary practice location
68 Main St
Centerbrook, CT 06409
Mailing address
PO Box 182
68 Main St
Centerbrook, CT 06409
Phone (860) 767-2266
Other providers in Centerbrook, CT
- Diane Elizabeth Gawronski
- Rachel McCabe Goodman
- Diana Harbison
- Helen Renate Kilby
- Lower Valley Chiropractic Physicians, LLC
- Robert A Mallimson
- Maxi Drug Inc
- Susan Mary McGrath
- Medical Equipment of Centerbrook, LLC
- Pamela M Murphy
All providers in Centerbrook, CT · Professional Counselor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.