Individual
SORALIS CAMACHO-IRIZARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
400 COLUMBUS AVE, ADULT PSYCHIATRIC CLINIC, NEW HAVEN, CT 06519-1233
(203) 503-3075
(203) 503-3296
Mailing address
400 COLUMBUS AVE, CREDENTIALING SPECIALIST, NEW HAVEN, CT 06519-1233
(203) 503-3000
(203) 503-3183
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3142
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008071041
—
CT
Enumeration date
08/24/2011
Last updated
11/01/2019
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