Provider Demographics
NPI:1124621941
Name:SCLAFANI, ABIGAIL (LADC)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:SCLAFANI
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:GRACE
Other - Last Name:RASMUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LADC
Mailing Address - Street 1:18 ARDI CT
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:CT
Mailing Address - Zip Code:06482-1592
Mailing Address - Country:US
Mailing Address - Phone:203-947-1188
Mailing Address - Fax:
Practice Address - Street 1:18 ARDI CT
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482-1592
Practice Address - Country:US
Practice Address - Phone:203-947-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001290101Y00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor