Healthcare Provider Details

I. General information

NPI: 1114479888
Provider Name (Legal Business Name): BEHAVIORAL HEALTH AND WELLNESS SOLUTIONS OF CT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2016
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3013 DIXWELL AVE
HAMDEN CT
06518-3527
US

IV. Provider business mailing address

31 TIMBERWOOD TRL
HAMDEN CT
06514-1159
US

V. Phone/Fax

Practice location:
  • Phone: 203-400-1884
  • Fax:
Mailing address:
  • Phone: 203-400-1884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number007256
License Number StateCT

VIII. Authorized Official

Name: MRS. JESSICA KATHLEEN MARSHALL
Title or Position: OWNER
Credential: LCSW
Phone: 203-400-1884