Individual
PATRICE ANTHIA MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3 NORTHWESTERN DR, BLOOMFIELD, CT 06002-3465
(860) 243-3477
(860) 243-3224
Mailing address
38 BENNETT CIR, HARTFORD, CT 06120-1153
(860) 985-0284
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
3824
CT
Other
Enumeration date
11/29/2016
Last updated
12/12/2019
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