Jeanbyk, Mary
Jeanbyk, Mary is an sole proprietor health care provider with primary practice located at 5 Church Ln Ste 5 , East Lyme CT 06333-1621. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jeanbyk, Mary can be contacted via phone (860) 235-1748.Contact Information
Primary practice address
5 Church Ln Ste 5
East Lyme CT 06333-1621
Phone: (860) 235-1748
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 003902 | Connecticut |
Profile Details
| NPI number | 1689052946 |
|---|---|
| LBN Legal business name | Jeanbyk, Mary |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 7th, 2015 |
| Last updated | May 7th, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689052946 | NPPES |
| Connecticut | Other | 13506405 | CAQH |
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