Provider Demographics
NPI:1144475609
Name:COON, LOIS JEAN (LPC)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:JEAN
Last Name:COON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:JEAN
Other - Last Name:COON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:476 FELT RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-2925
Mailing Address - Country:US
Mailing Address - Phone:860-644-4434
Mailing Address - Fax:
Practice Address - Street 1:476 FELT RD
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2925
Practice Address - Country:US
Practice Address - Phone:860-644-4434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000545101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health