Individual
MICHELLE STALLWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
15 CHESTERFIELD RD, EAST LYME, CT 06333-1730
(860) 514-3664
Mailing address
2 LORENZ INDUSTRIAL PARKWAY, LEDYARD, CT 06339-1946
(860) 464-3045
(860) 464-3044
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
000432
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811123912
—
CT
Enumeration date
06/03/2009
Last updated
01/01/2026
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