Provider Demographics
NPI:1811392830
Name:MANUEL, NELLE ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:NELLE
Middle Name:ELIZABETH
Last Name:MANUEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:372 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-2250
Mailing Address - Country:US
Mailing Address - Phone:203-430-3507
Mailing Address - Fax:
Practice Address - Street 1:372 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-2250
Practice Address - Country:US
Practice Address - Phone:203-430-3507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-03
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0078841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical