Healthcare Provider Details
I. General information
NPI: 1821950387
Provider Name (Legal Business Name): ELM STATE CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
966 S MAIN ST
PLANTSVILLE CT
06479-1645
US
IV. Provider business mailing address
966 S MAIN ST
PLANTSVILLE CT
06479-1645
US
V. Phone/Fax
- Phone: 860-736-5386
- Fax: 860-263-8291
- Phone: 860-736-5386
- Fax: 860-263-8291
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
ALBINI
Title or Position: DIRECTOR
Credential: LPC
Phone: 860-620-7748