Healthcare Provider Details

I. General information

NPI: 1770068520
Provider Name (Legal Business Name): JPA HEALTH AND WELLNESS, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 11/07/2021
Certification Date: 11/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 BRIDGEPORT AVE, SUITE 100
SHELTON CT
06484-4700
US

IV. Provider business mailing address

19 ELGIN RD
MILFORD CT
06460-3717
US

V. Phone/Fax

Practice location:
  • Phone: 203-823-6313
  • Fax:
Mailing address:
  • Phone: 203-823-6313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. JENNIFER MARIE PASKIEWICZ
Title or Position: PSYCHOTHERAPIST/ OWNER
Credential: MS, LMFT
Phone: 203-823-6313