Individual
ELISABETH D PERALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC,MSW,BSW,ASW
Contact information
Practice address
402 E MAIN ST, WATERBURY, CT 06702-1701
(203) 574-9000
(203) 574-9006
Mailing address
141 E MAIN ST, 4TH FLOOR ADMINISTRATION, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
2362
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060669107
UNITED BEHAVIORAL HEALTH GRP/FACILITY
CT
05
—
0808064941
—
CT
01
—
13818187
CAQH
CT
01
—
D339210 402 E MAIN
BEACON HEALTH STRATEGIES
CT
01
—
PENDING
CIGNA BEHAVIORAL HEALTH
CT
Enumeration date
04/08/2015
Last updated
09/27/2024
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