Park, Jessica
Park, Jessica is an sole proprietor health care provider with primary practice located at 11 High St Ste 209 , Suffield CT 06078-2125. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Park, Jessica can be contacted via phone (860) 578-2141.Contact Information
Primary practice address
11 High St Ste 209
Suffield CT 06078-2125
Phone: (860) 578-2141
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1727 | Connecticut |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 11763 | Connecticut |
Profile Details
| NPI number | 1902422488 |
|---|---|
| LBN Legal business name | Park, Jessica |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 22nd, 2020 |
| Last updated | May 7th, 2022 - about 3 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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