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NPI Code Detail

MEDICARE: JEANNA M SPATTA LCSW

MEDICARE: JEANNA M SPATTA LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker006289CT

General Provider Information

NPI Number : 1063585461
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNA M SPATTA LCSW
Provider Business Mailing Address
First Line : 75 WEST ST
Second Line :
City : DANBURY
State : CT
Zip : 06810-6528
Country : US
Telephone Number : 203-748-5689
Fax Number : 203-790-8183
Provider Business Practice Location Address
First Line : 75 WEST ST
Second Line :
City : DANBURY
State : CT
Zip : 06810-6528
Country : US
Telephone Number : 203-748-5689
Fax Number : 203-790-8183
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2006
Last Update Date : 07/08/2007

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Directions to “ JEANNA M SPATTA LCSW” Practice Location

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