Provider Demographics
NPI:1972387488
Name:ELEGBEDE, TANESHA N (LPC)
Entity type:Individual
Prefix:DR
First Name:TANESHA
Middle Name:N
Last Name:ELEGBEDE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TANESHA
Other - Middle Name:N
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 MEADOWVIEW LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-1627
Mailing Address - Country:US
Mailing Address - Phone:860-966-7092
Mailing Address - Fax:
Practice Address - Street 1:3 MEADOWVIEW LN
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-1627
Practice Address - Country:US
Practice Address - Phone:860-966-7092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6651101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional