Provider Demographics
NPI:1417668245
Name:GLEED, COLETTE MAREE (LPCA)
Entity type:Individual
Prefix:
First Name:COLETTE
Middle Name:MAREE
Last Name:GLEED
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:COLIN
Other - Middle Name:THOMAS
Other - Last Name:GLEED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 MULLEN RD
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-7105
Mailing Address - Country:US
Mailing Address - Phone:203-684-9719
Mailing Address - Fax:
Practice Address - Street 1:458 GRAND AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513-3856
Practice Address - Country:US
Practice Address - Phone:203-752-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5872101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health