Healthcare Provider Details

I. General information

NPI: 1417845983
Provider Name (Legal Business Name): JESSICA BUEHRING LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 HEMPSTEAD ST
NEW LONDON CT
06320-6204
US

IV. Provider business mailing address

PO BOX 120
NEW LONDON CT
06320-0120
US

V. Phone/Fax

Practice location:
  • Phone: 860-437-4550
  • Fax: 860-449-1869
Mailing address:
  • Phone: 860-437-4550
  • Fax: 860-449-1869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number9348
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: