Individual
DEANNA BONAVENTURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
352 STATE ST, NORTH HAVEN, CT 06473-3108
(203) 781-4600
(203) 498-3820
Mailing address
1 LONG WHARF DR, NEW HAVEN, CT 06511-5991
(203) 781-4600
(203) 781-4624
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3305
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004082286
—
CT
05
—
008022626
—
CT
05
—
008056168
—
CT
05
—
008077565
—
CT
05
—
500000315
—
CT
Enumeration date
01/09/2018
Last updated
02/14/2018
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