Individual
MR. LUKE J. GILLERAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, NCC, LACD, CCDP
Contact information
Practice address
1 LONG WHARF DR, SUITE 321, NEW HAVEN, CT 06511-5991
(203) 781-4357
Mailing address
245 UNQUOWA RD, APT #126, FAIRFIELD, CT 06824-5057
(203) 520-3465
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000857
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004041000
—
CT
05
—
008003745
—
CT
05
—
008038039
—
CT
Enumeration date
12/29/2008
Last updated
01/07/2013
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