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Individual

MR. KEVIN LARDNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
1783 MERIDEN WATERBURY TURNPIKE, SUITE K 11, SOUTHINGTON, CT 06489-0268
(203) 404-1010
(860) 426-2898
Mailing address
1 LONG WHARF DR STE 321, NEW HAVEN, CT 06511-5946
(203) 781-4600
(203) 781-4624

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
103TA0400X
Addiction (Substance Use Disorder) Psychologist
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary
10383
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004041000
CT
05
004217099
CT
05
008003745
CT
05
008083698
CT
Enumeration date
06/23/2014
Last updated
01/22/2020
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