Provider Demographics
NPI:1134511173
Name:ELYON PROFESSIONAL COUNSELING LLC
Entity Type:Organization
Organization Name:ELYON PROFESSIONAL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:PILEGGI CAVIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC/LMHC, NCC
Authorized Official - Phone:203-570-1568
Mailing Address - Street 1:70 STRAWBERRY HILL AVE APT 2-2A
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2622
Mailing Address - Country:US
Mailing Address - Phone:203-570-1568
Mailing Address - Fax:
Practice Address - Street 1:38 W END AVE
Practice Address - Street 2:
Practice Address - City:OLD GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06870-1606
Practice Address - Country:US
Practice Address - Phone:203-570-1568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001969101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty