Basic Information
| Provider Information | |||||||||
| NPI: | 1750565974 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHREIBER | ||||||||
| FirstName: | ELENA | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 587 E MIDDLE TPKE | ||||||||
| Address2: | |||||||||
| City: | MANCHESTER | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060403731 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606463888 | ||||||||
| FaxNumber: | 8606454132 | ||||||||
| Practice Location | |||||||||
| Address1: | 24 HENDEE RD | ||||||||
| Address2: | |||||||||
| City: | COVENTRY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 062381540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8607429257 | ||||||||
| FaxNumber: | 8607425086 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/24/2007 | ||||||||
| LastUpdateDate: | 11/16/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 001317 | CT | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.