Healthcare Provider Details

I. General information

NPI: 1295162600
Provider Name (Legal Business Name): JONISHA ANN SINCLAIR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JONISHA KING

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 11/02/2025
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 JEFFREY LN
BLOOMFIELD CT
06002-1823
US

IV. Provider business mailing address

17 JEFFREY LN
BLOOMFIELD CT
06002-1823
US

V. Phone/Fax

Practice location:
  • Phone: 860-789-7524
  • Fax:
Mailing address:
  • Phone: 860-789-7524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13811
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: