Organization
LIFTED, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN NICOLL MACAULEY LMFT (OWNER)
(860) 334-6135
Entity
Organization
Contact information
Practice address
49 RANDOLPH RD, MIDDLETOWN, CT 06457-5606
(860) 334-6135
Mailing address
49 RANDOLPH RD, MIDDLETOWN, CT 06457-5606
(860) 334-6135
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/25/2025
Last updated
06/25/2025
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