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Individual

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Active
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Individual

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Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA,LPC, LADC

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDP00383
RI
101YP2500X
Professional Counselor
Primary
6181
CT
101YP2500X
Professional Counselor
LPC.0013276
CO

Other

Enumeration date
11/02/2006
Last updated
04/06/2026
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