Provider Demographics
NPI:1659035566
Name:SUMMERS, ADELE (LMFT)
Entity Type:Individual
Prefix:
First Name:ADELE
Middle Name:
Last Name:SUMMERS
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 1:310 THOMPSON ST # B
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06513-1316
Mailing Address - Country:US
Mailing Address - Phone:908-590-0786
Mailing Address - Fax:
Practice Address - Street 1:310 THOMPSON ST # B
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513-1316
Practice Address - Country:US
Practice Address - Phone:908-590-0786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002619106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty