Provider Demographics
NPI:1184041535
Name:ALLAN, HALEY ELISE (LPC)
Entity Type:Individual
Prefix:MS
First Name:HALEY
Middle Name:ELISE
Last Name:ALLAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 DRAHER AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3566
Mailing Address - Country:US
Mailing Address - Phone:203-802-4346
Mailing Address - Fax:
Practice Address - Street 1:117 DRAHER AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3566
Practice Address - Country:US
Practice Address - Phone:203-802-4346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR3116101YM0800X
CT4304101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health