Provider Demographics
NPI:1952890659
Name:AJELLO, MORGAN ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:ANN
Last Name:AJELLO
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 1:1 FELLOWS RD APT 47
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CT
Mailing Address - Zip Code:06370-1624
Mailing Address - Country:US
Mailing Address - Phone:860-334-5900
Mailing Address - Fax:
Practice Address - Street 1:1 FELLOWS RD APT 47
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CT
Practice Address - Zip Code:06370-1624
Practice Address - Country:US
Practice Address - Phone:959-265-2947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT46.003444101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT46.003444Medicaid