Provider Demographics
NPI:1326409525
Name:CLAVER-OBINNA, PATIENCE ATTAH
Entity Type:Individual
Prefix:
First Name:PATIENCE
Middle Name:ATTAH
Last Name:CLAVER-OBINNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 FRANCES HUNTER DR
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3629
Mailing Address - Country:US
Mailing Address - Phone:203-668-2590
Mailing Address - Fax:
Practice Address - Street 1:270 CENTER ST
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-4400
Practice Address - Country:US
Practice Address - Phone:203-668-2590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001056101YA0400X
CT0094911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)