Individual
MR. ERIBERTO SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC, CAC, NOTARY
Contact information
Practice address
139 CHURCH ST, MIDDLETOWN, CT 06457-3619
(203) 450-9322
Mailing address
PO BOX 462, BRIDGEPORT, CT 06601-0462
(203) 450-9322
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1424
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1424
CONNECTICUT DEPARTMENT OF PUBLIC HEALTH
CT
01
—
5956
CONNECTICUT CERTIFICATIONS BOARD
CT
Enumeration date
09/06/2018
Last updated
06/27/2024
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