Formica Burnham, Elaine
Formica Burnham, Elaine is an sole proprietor health care provider with primary practice located at 378 Long Hill Rd , South Windsor CT 06074-4217. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Formica Burnham, Elaine can be contacted via phone (860) 528-7005.Contact Information
Primary practice address
378 Long Hill Rd
South Windsor CT 06074-4217
Phone: (860) 528-7005
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 000698 | Connecticut |
Profile Details
| NPI number | 1881871606 |
|---|---|
| LBN Legal business name | Formica Burnham, Elaine |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 23rd, 2008 |
| Last updated | Jan 23rd, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881871606 | NPPES |
| Connecticut | Other | 00698 | LPC |
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