Lusa, Jennifer V

Lusa, Jennifer V is an individual health care provider with primary practice located at 78 Eastern Blvd Ste 2 , Glastonbury CT 06033-4325. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Lusa, Jennifer V can be contacted via phone (860) 652-0428.

Contact Information

Primary practice address
78 Eastern Blvd Ste 2 Glastonbury CT 06033-4325
Phone: (860) 652-0428
Fax: (860) 652-0081
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 004754 Connecticut

Profile Details

NPI number 1629010913
LBN Legal business name Lusa, Jennifer V
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Nov 12th, 2022 - about 2 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 1629010913 NPPES
Connecticut Other 004754 LCSW CT LICENSE #

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