| Ellis Psychotherapy, Training & Consultation | |
|
21 Farnham Ave Apt 1 New Haven CT 06515-1265 | |
| (475) 441-4082 | |
| Not Available |
| Full Name | Ellis Psychotherapy, Training & Consultation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 21 Farnham Ave Apt 1, New Haven, Connecticut |
| Authorized Official Name and Position | Sylvadra Ellis (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 4754414082 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellis Psychotherapy, Training & Consultation 33 Dixwell Ave # 239 New Haven CT 06511-3403 Ph: (475) 441-4082 | Ellis Psychotherapy, Training & Consultation 21 Farnham Ave Apt 1 New Haven CT 06515-1265 Ph: (475) 441-4082 |
| NPI Number | 1013670868 |
|---|---|
| Provider Enumeration Date | 10/19/2021 |
| Last Update Date | 10/20/2021 |
| Certification Date | 10/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013670868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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