Organization
ABUNDANT LIFE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIAN LASHAE OUTLAW LCSW (OWNER)
(203) 317-3333
Entity
Organization
Contact information
Practice address
21 W MAIN ST FL 4, WATERBURY, CT 06702-2013
(203) 317-3333
(203) 841-0304
Mailing address
21 W MAIN ST FL 4, WATERBURY, CT 06702-2013
(203) 317-3333
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
008874
CT
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
008874
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
01/11/2017
Last updated
11/28/2023
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