=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821950387
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ELM STATE CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/02/2025
-----------------------------------------------------
Last Update Date | 12/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 966 S MAIN ST
-----------------------------------------------------
City | PLANTSVILLE
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06479-1645
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-736-5386
-----------------------------------------------------
Fax | 860-263-8291
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 966 S MAIN ST
-----------------------------------------------------
City | PLANTSVILLE
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06479-1645
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-736-5386
-----------------------------------------------------
Fax | 860-263-8291
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | CHRISTOPHER ALBINI
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 860-620-7748
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Registered Nurse
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------