Healthcare Provider Details

I. General information

NPI: 1871315275
Provider Name (Legal Business Name): KARLI ELIZABETH IMPERATO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 WEST ST
DANBURY CT
06810-6531
US

IV. Provider business mailing address

80 WEST ST
DANBURY CT
06810-6531
US

V. Phone/Fax

Practice location:
  • Phone: 203-755-2868
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10502
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: