Provider Demographics
NPI:1184948481
Name:FOSS-RAND, MARIA S (LPC)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:S
Last Name:FOSS-RAND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BILLOW RD
Mailing Address - Street 2:
Mailing Address - City:OLD SEYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475
Mailing Address - Country:US
Mailing Address - Phone:860-661-1133
Mailing Address - Fax:860-469-2966
Practice Address - Street 1:251 MAIN ST.
Practice Address - Street 2:SUITE 100
Practice Address - City:OLD SEYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475
Practice Address - Country:US
Practice Address - Phone:860-661-1133
Practice Address - Fax:860-469-2966
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CT2253101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor