Organization
MARIETTA WHITTLESEY LPC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIETTA H WHITTLESEY LPC (PRESIDENT)
(860) 435-2777
Entity
Organization
Contact information
Practice address
184 MAIN ST, LAKEVILLE, CT 06039-1100
(860) 435-2777
(860) 435-2777
Mailing address
PO BOX 125, ANCRAMDALE, NY 12503-0125
(860) 435-2777
(860) 435-2777
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2678
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008057031
—
CT
Enumeration date
02/27/2017
Last updated
02/27/2017
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