Provider Demographics
NPI:1427250729
Name:MEDRANO, MARIANELA D (LPC)
Entity type:Individual
Prefix:
First Name:MARIANELA
Middle Name:D
Last Name:MEDRANO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MARIANELA
Other - Middle Name:D
Other - Last Name:MEDRANO-MARRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:150 GLEN VIEW TER
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-1417
Mailing Address - Country:US
Mailing Address - Phone:203-770-4338
Mailing Address - Fax:
Practice Address - Street 1:150 GLEN VIEW TER
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1417
Practice Address - Country:US
Practice Address - Phone:203-770-4338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional