Individual
ALLIETA ELMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
54 E RAMSDELL ST, NEW HAVEN, CT 06515-1140
(203) 337-9943
(203) 387-6533
Mailing address
1 LONG WHARF DR, SUITE 321, NEW HAVEN, CT 06511-5991
(203) 781-4600
(203) 781-4624
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1127
CT
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
26985
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008023170
—
CT
05
—
008024427
—
CT
05
—
008039745
—
CT
01
—
008058232
ANDERSON MEDICAID
CT
Enumeration date
04/02/2015
Last updated
03/28/2023
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