Provider Demographics
NPI:1336616085
Name:PABON, ALBA GISELLE (LPC)
Entity Type:Individual
Prefix:
First Name:ALBA
Middle Name:GISELLE
Last Name:PABON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-6014
Mailing Address - Country:US
Mailing Address - Phone:203-464-2054
Mailing Address - Fax:
Practice Address - Street 1:144 EAST AVE
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-6014
Practice Address - Country:US
Practice Address - Phone:203-464-2054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-31
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003539101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional