Camacho-Irizarry, Soralis

Camacho-Irizarry, Soralis is an individual health care provider with primary practice located at 400 Columbus Ave Adult Psychiatric Clinic, New Haven CT 06519-1233. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Camacho-Irizarry, Soralis can be contacted via phone (203) 503-3075.

Contact Information

Primary practice address
400 Columbus Ave Adult Psychiatric Clinic New Haven CT 06519-1233
Phone: (203) 503-3075
Fax: (203) 503-3296
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 3142 Connecticut

Profile Details

NPI number 1124308994
LBN Legal business name Camacho-Irizarry, Soralis
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2011
Last updated Nov 1st, 2019 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124308994 NPPES
Connecticut MEDICAID 008071041

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