| Jessica R. Page, Llc | |
|
57 Plains Rd Ste 1b Milford CT 06461-2573 | |
| (203) 913-6883 | |
| Not Available |
| Full Name | Jessica R. Page, Llc |
|---|---|
| Speciality | Counselor |
| Location | 57 Plains Rd Ste 1b, Milford, Connecticut |
| Authorized Official Name and Position | Grace Cullen (MEDICAL BILLING MANAGER) |
| Authorized Official Contact | 2033675515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica R. Page, Llc 7 Glenarden Rd Trumbull CT 06611-5515 Ph: (203) 913-6883 | Jessica R. Page, Llc 57 Plains Rd Ste 1b Milford CT 06461-2573 Ph: (203) 913-6883 |
| NPI Number | 1457999880 |
|---|---|
| Provider Enumeration Date | 12/17/2019 |
| Last Update Date | 12/17/2019 |
| Certification Date | 12/17/2019 |
| Medicare PECOS PAC ID | 9133542103 |
|---|---|
| Medicare Enrollment ID | O20200709000689 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457999880 | NPI | - | NPPES |
| 004069985 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Provider Name | Jessica R Page |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902179690 PECOS PAC ID: 5890125660 Enrollment ID: I20200417002096 |
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