Individual
GREGG NODELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC, LMFT
Contact information
Practice address
184 FRONT AVE, WEST HAVEN, CT 06516-2836
(203) 781-4600
Mailing address
1 LONG WHARF DR, STE321, NEW HAVEN, CT 06511-5991
(203) 781-4600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000973
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008038052
—
CT
Enumeration date
12/13/2011
Last updated
02/07/2017
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