Individual
SHAUNTEL LUCIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
430 NEW PARK AVE, WEST HARTFORD, CT 06110-1142
(844) 866-8336
Mailing address
271 WAINWRIGHT ST, NEWARK, NJ 07112-3073
(347) 493-6056
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
37AC00652500
NJ
101YP2500X
Professional Counselor
Primary
007306
CT
Other
Enumeration date
05/07/2022
Last updated
12/02/2024
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