Provider Demographics
NPI:1891238234
Name:ASHLEY CHAMBRELLO, LLC
Entity Type:Organization
Organization Name:ASHLEY CHAMBRELLO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBRELLO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-301-6880
Mailing Address - Street 1:45 S MAIN ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2441
Mailing Address - Country:US
Mailing Address - Phone:860-782-0420
Mailing Address - Fax:
Practice Address - Street 1:3285 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-3803
Practice Address - Country:US
Practice Address - Phone:860-301-6880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-01
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1853106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty