Organization
MICHELLE PELLIN MS MA LPC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE PELLIN LPC (OWNER)
(860) 805-7819
Entity
Organization
Contact information
Practice address
352 MAIN ST, DURHAM, CT 06422-1645
(860) 805-7819
Mailing address
32 BUTTONHOOK DR, PORTLAND, CT 06480-1375
(860) 805-7819
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008059952
—
CT
Enumeration date
10/24/2018
Last updated
10/24/2018
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