Provider Demographics
NPI:1306685672
Name:ALLERS, CHAUNCEY (LADC)
Entity type:Individual
Prefix:
First Name:CHAUNCEY
Middle Name:
Last Name:ALLERS
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MOUNTAINVIEW TER UNIT 4134
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-4183
Mailing Address - Country:US
Mailing Address - Phone:203-644-8908
Mailing Address - Fax:
Practice Address - Street 1:1098 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4705
Practice Address - Country:US
Practice Address - Phone:860-973-0213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1547101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)