Provider Demographics
NPI:1679656631
Name:BAUGHN, ELAINE BENTLEY (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:BENTLEY
Last Name:BAUGHN
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 1:44R LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:BOZRAH
Mailing Address - State:CT
Mailing Address - Zip Code:06334
Mailing Address - Country:US
Mailing Address - Phone:860-892-4088
Mailing Address - Fax:860-376-5878
Practice Address - Street 1:44R LEBANON RD
Practice Address - Street 2:
Practice Address - City:BOZRAH
Practice Address - State:CT
Practice Address - Zip Code:06334
Practice Address - Country:US
Practice Address - Phone:860-892-4088
Practice Address - Fax:860-376-5878
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTLMFT000585106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist