Healthcare Provider Details

I. General information

NPI: 1609147404
Provider Name (Legal Business Name): RICHARD DABLE LADC, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2012
Last Update Date: 02/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PECK RD STE 2104
TORRINGTON CT
06790-6123
US

IV. Provider business mailing address

38 OLD RIDGEBURY RD
DANBURY CT
06810-5128
US

V. Phone/Fax

Practice location:
  • Phone: 860-482-2613
  • Fax: 860-482-2638
Mailing address:
  • Phone: 203-792-4515
  • Fax: 203-748-2632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number000650
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number001961
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: