Provider Demographics
NPI:1467591180
Name:ROBBINS, ELLEN FAITH (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:FAITH
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 904
Mailing Address - Street 2:259 ALBANY TURNPIKE
Mailing Address - City:CANTON
Mailing Address - State:CT
Mailing Address - Zip Code:06019-0904
Mailing Address - Country:US
Mailing Address - Phone:860-693-6344
Mailing Address - Fax:860-760-6366
Practice Address - Street 1:259 ALBANY TPKE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:CT
Practice Address - Zip Code:06019-2512
Practice Address - Country:US
Practice Address - Phone:860-693-6344
Practice Address - Fax:860-760-6366
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000691106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP2749374OtherOXFORD
CT410000691CT1OtherBCBS