Organization
THRIVE AND GROW PSYCHOTHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA JOHANNS LPC (CLINICAL DIRECTOR)
(860) 322-6392
Entity
Organization
Contact information
Practice address
435 BUCKLAND ROAD, C/O LISA JOHANNS, LPC, SOUTH WINDSOR, CT 06074
(860) 322-6392
Mailing address
2389 MAIN ST STE 100, GLASTONBURY, CT 06033-4617
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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