Individual
WALTER MABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
54 E RAMSDELL ST, NEW HAVEN, CT 06515-1140
(203) 781-4600
(203) 781-4624
Mailing address
1 LONG WHARF DR STE 321, NEW HAVEN, CT 06511-5946
(203) 781-4600
(203) 781-4624
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1441
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008023170
—
CT
05
—
008024427
—
CT
05
—
008039745
—
CT
05
—
008042339
—
CT
05
—
008107965
—
CT
Enumeration date
01/12/2022
Last updated
02/14/2022
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