Healthcare Provider Details

I. General information

NPI: 1275685992
Provider Name (Legal Business Name): LAURA JEAN PARSONS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SOUTHEASTERN MENTAL HEALTH AUTHORITY 401 WEST THAMES ST BLDG 301
NORWICH CT
06360
US

IV. Provider business mailing address

SOUTHEASTERN MENTAL HEALTH AUTHORITY 401 WEST THAMES ST BLDG 301
NORWICH CT
06360
US

V. Phone/Fax

Practice location:
  • Phone: 860-859-4674
  • Fax: 860-859-4790
Mailing address:
  • Phone: 860-859-4674
  • Fax: 860-859-4790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number004679
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: