Provider Demographics
NPI:1336679703
Name:TRISTAALBERT, LLC
Entity Type:Organization
Organization Name:TRISTAALBERT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:860-371-7715
Mailing Address - Street 1:13 MOUNTAIN LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:CHAPLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06235-2651
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13 MOUNTAIN LAUREL LN
Practice Address - Street 2:
Practice Address - City:CHAPLIN
Practice Address - State:CT
Practice Address - Zip Code:06235-2651
Practice Address - Country:US
Practice Address - Phone:860-371-7715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002952101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty