Healthcare Provider Details

I. General information

NPI: 1992674857
Provider Name (Legal Business Name): JESSICA FICO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2025
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 HILLSIDE AVE
NAUGATUCK CT
06770-4019
US

IV. Provider business mailing address

201 COMMONS PARK S UNIT 405
STAMFORD CT
06902-7065
US

V. Phone/Fax

Practice location:
  • Phone: 203-729-0341
  • Fax:
Mailing address:
  • Phone: 203-305-4448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15968
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: