Individual
ELISA M RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
184 FRONT AVE, WEST HAVEN, CT 06516-2836
(203) 781-4600
(203) 781-4624
Mailing address
1 LONG WHARF DR STE 321, NEW HAVEN, CT 06511-5946
(203) 781-4600
(203) 781-4624
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1578
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008068298
—
CT
05
—
008068631
—
CT
05
—
008068669
—
CT
05
—
008068749
—
CT
05
—
008129668
—
CT
Enumeration date
08/26/2024
Last updated
09/18/2024
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