Luysterborghs, Jonathan A.

Luysterborghs, Jonathan A. is an individual health care provider with primary practice located at 635 Main St , Middletown CT 06457-2718. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Luysterborghs, Jonathan A. can be contacted via phone (860) 347-6971.

Contact Information

Primary practice address
635 Main St Middletown CT 06457-2718
Phone: (860) 347-6971
Fax: (860) 638-6601
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 004330 Connecticut

Profile Details

NPI number 1821055716
LBN Legal business name Luysterborghs, Jonathan A.
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Jul 8th, 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 1821055716 NPPES
Connecticut Other 382736 VALUEOPTIONS
Connecticut Other 191056 VALUEOPTIONS

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