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General NPI Number Information
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NPI Number | 1134511173
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Entity Type | Organization
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Legal Business Name | ELYON PROFESSIONAL COUNSELING LLC
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Dates
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Enumeration Date | 02/27/2015
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Last Update Date | 02/27/2015
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Provider Practice Location Address
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Address Line | 38 W END AVE
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City | OLD GREENWICH
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State | CT
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Zip | 06870-1606
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Country | US
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Telephone | 203-570-1568
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Fax |
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Provider Business Mailing Address
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Address Line | 70 STRAWBERRY HILL AVE APT 2-2A
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City | STAMFORD
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State | CT
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Zip | 06902-2622
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Country | US
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Telephone | 203-570-1568
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Fax |
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Authorized Official
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Title or Position | OWNER / PSYCHOTHERAPIST
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Name | MRS. CARLA PILEGGI CAVIOLA
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Credential | MA, LPC/LMHC, NCC
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Telephone | 203-570-1568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 001969
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License Number State | CT
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