Individual
MS. LISA MALLENBAUM GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
489 POST RD E, WESTPORT, CT 06880-4435
(203) 493-1151
Mailing address
13 OREMS LN, WILTON, CT 06897-4022
(203) 858-4808
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5790
CT
101YP2500X
Professional Counselor
5790
CT
Other
Enumeration date
09/23/2022
Last updated
09/23/2022
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