Healthcare Provider Details

I. General information

NPI: 1619885530
Provider Name (Legal Business Name): ELANA GENGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 PARK ST
NEW CANAAN CT
06840-4532
US

IV. Provider business mailing address

72 PARK ST STE 211
NEW CANAAN CT
06840-4532
US

V. Phone/Fax

Practice location:
  • Phone: 917-913-6700
  • Fax:
Mailing address:
  • Phone: 917-913-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number46.010085
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: