| Jenifer L Gietek Lcsw Llc | |
|
891 Main Street 2nd Floor Office D South Glastonbury CT 06073 | |
| (860) 508-6633 | |
| Not Available |
| Full Name | Jenifer L Gietek Lcsw Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 891 Main Street, South Glastonbury, Connecticut |
| Authorized Official Name and Position | Jenifer Lee Gietek (OWNER) |
| Authorized Official Contact | 8605086633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jenifer L Gietek Lcsw Llc Po Box 128 Tolland CT 06084-0128 Ph: (860) 508-6633 | Jenifer L Gietek Lcsw Llc 891 Main Street 2nd Floor Office D South Glastonbury CT 06073 Ph: (860) 508-6633 |
| NPI Number | 1689091308 |
|---|---|
| Provider Enumeration Date | 03/19/2014 |
| Last Update Date | 03/19/2014 |
| Medicare PECOS PAC ID | 5890098743 |
|---|---|
| Medicare Enrollment ID | O20160127000040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689091308 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 008070 (Connecticut) | Primary |
| Provider Name | Jenifer L Gietek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821332115 PECOS PAC ID: 8820240997 Enrollment ID: I20121219000012 |
Catherine M. Morrell, Psyd., Licensed Clinical Psychologist, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 891 Main Street, South Glastonbury, CT 06073 Phone: 860-430-1882 |