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Individual

EARLE B SANFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC, LADC

Contact information

Practice address
495 CONGRESS AVE, NEW HAVEN, CT 06519-1312
(203) 781-4600
(203) 781-4624
Mailing address
1 LONG WHARF DR, STE 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
000985
CT
101YP2500X
Professional Counselor
Primary
001084
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004082260
CT
05
008001325
CT
05
008022622
CT
05
008038054
CT
Enumeration date
12/08/2011
Last updated
12/07/2012
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