Provider Demographics
NPI:1790334076
Name:ROBLES, ELAINE MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:MARIE
Last Name:ROBLES
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 1:1125 NEW BRITAIN AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-2420
Mailing Address - Country:US
Mailing Address - Phone:860-506-5371
Mailing Address - Fax:
Practice Address - Street 1:1125 NEW BRITAIN AVE STE 202
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-2420
Practice Address - Country:US
Practice Address - Phone:860-506-5371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0107161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical