# KATHRYN MCNEISH LMFT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902364847
- **Authorized official:** GRACE CULLEN (MEDICAL BILLING MANAGER)
- **Authorized official phone:** (203) 368-5515

## Contact information

- **Practice address:** 140 LAKE RIDGE RD, SOUTHBURY, CT 06488-4161
- **Practice address phone:** (203) 900-7137
- **Mailing address:** 140 LAKE RIDGE RD, SOUTHBURY, CT 06488-4161
- **Mailing address phone:** (203) 900-7137

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 03/11/2019
- **Last updated:** 03/11/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004069985 | — | CT |