Healthcare Provider Details

I. General information

NPI: 1083363667
Provider Name (Legal Business Name): CARISA ELI SANCHEZ LCSW, LADC, ICADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

687 STRAITS TPKE STE 1A
MIDDLEBURY CT
06762-2846
US

IV. Provider business mailing address

687 STRAITS TPKE STE 1A
MIDDLEBURY CT
06762-2846
US

V. Phone/Fax

Practice location:
  • Phone: 917-397-6742
  • Fax:
Mailing address:
  • Phone: 917-397-6742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15694
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1466
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: