Provider Demographics
NPI:1235420746
Name:RAPHAEL-TOMKINS, ELANA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELANA
Middle Name:
Last Name:RAPHAEL-TOMKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 GOOSE LN STE 6
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2100
Mailing Address - Country:US
Mailing Address - Phone:203-623-7306
Mailing Address - Fax:
Practice Address - Street 1:1575 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2319
Practice Address - Country:US
Practice Address - Phone:203-623-7306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0076161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical