| Thriving Journey Therapy, Pllc | |
|
1224 Mill St Ste B001 East Berlin CT 06023-1166 | |
| (860) 578-2020 | |
| Not Available |
| Full Name | Thriving Journey Therapy, Pllc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1224 Mill St Ste B001, East Berlin, Connecticut |
| Authorized Official Name and Position | Lisa Lacen (OWNER) |
| Authorized Official Contact | 8605782020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thriving Journey Therapy, Pllc 100 Beacon St Newington CT 06111-4702 Ph: (860) 578-2020 | Thriving Journey Therapy, Pllc 1224 Mill St Ste B001 East Berlin CT 06023-1166 Ph: (860) 578-2020 |
| NPI Number | 1942840319 |
|---|---|
| Provider Enumeration Date | 01/13/2020 |
| Last Update Date | 02/16/2024 |
| Certification Date | 02/16/2024 |
| Medicare PECOS PAC ID | 3072957687 |
|---|---|
| Medicare Enrollment ID | O20240221003604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942840319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Lisa Lacen |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1306193966 PECOS PAC ID: 8426492034 Enrollment ID: I20240221003722 |
| Provider Name | Nancy Jean Wohlrabe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124244355 PECOS PAC ID: 5799974028 Enrollment ID: I20240221003802 |
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