Individual
HECTOR G LIZCANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW LADC
Contact information
Practice address
904 STATE ST, NEW HAVEN, CT 06511-3921
(203) 624-7710
Mailing address
152 MAPLE ST, BRANFORD, CT 06405-4517
(203) 494-0333
(203) 974-5850
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LADC 000190
CT
1041C0700X
Clinical Social Worker
Primary
003861
CT
1041C0700X
Clinical Social Worker
LCSW003861
CT
Other
Enumeration date
12/27/2006
Last updated
01/22/2020
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