Jay, Mark William

Jay, Mark William is an sole proprietor health care provider with primary practice located at 1031 Farmington Ave , Farmington CT 06032. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Jay, Mark William can be contacted via phone (860) 677-2550.

Contact Information

Primary practice address
1031 Farmington Ave Farmington CT 06032
Phone: (860) 677-2550
Fax: (860) 677-4975
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 003395 Connecticut

Profile Details

NPI number 1982663647
LBN Legal business name Jay, Mark William
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 21st, 2006
Last updated Dec 17th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982663647 NPPES
Other P1120226 OXFORD
Other 189634 OXFORD
Other 140003395CT04 OXFORD

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