Provider Demographics
NPI:1063954360
Name:ALLEYNE COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:ALLEYNE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAKESHA
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:ALLEYNE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LADC
Authorized Official - Phone:203-610-5315
Mailing Address - Street 1:1049 HARTFORD TPKE
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-3039
Mailing Address - Country:US
Mailing Address - Phone:203-610-5315
Mailing Address - Fax:
Practice Address - Street 1:410 STATE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-3147
Practice Address - Country:US
Practice Address - Phone:203-610-5315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000913101YA0400X
CT007576104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty