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NPI Code Detail

MEDICARE: JADA PT MIDDLETON LMSW

MEDICARE: JADA PT MIDDLETON LMSW
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
1104100000XSocial Worker10457CT

General Provider Information

NPI Number : 1407713688
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADA PT MIDDLETON LMSW
Provider Business Mailing Address
First Line : 2 WATERSIDE XING STE 401
Second Line :
City : WINDSOR
State : CT
Zip : 06095-1588
Country : US
Telephone Number : 860-731-5522
Fax Number : 860-731-5536
Provider Business Practice Location Address
First Line : 444 CENTER ST
Second Line :
City : MANCHESTER
State : CT
Zip : 06040-3926
Country : US
Telephone Number : 860-731-5522
Fax Number : 860-731-5536
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2026
Last Update Date : 01/08/2026

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Directions to “ JADA PT MIDDLETON LMSW” Practice Location

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