Healthcare Provider Details

I. General information

NPI: 1902743388
Provider Name (Legal Business Name): JASMIN MARCEL JOINER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

847 W MAIN ST
BRANFORD CT
06405-3455
US

IV. Provider business mailing address

414 CENTRAL AVE
NEW HAVEN CT
06515-2208
US

V. Phone/Fax

Practice location:
  • Phone: 203-507-4243
  • Fax:
Mailing address:
  • Phone: 203-507-4243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6188
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: