Healthcare Provider Details

I. General information

NPI: 1316484132
Provider Name (Legal Business Name): JAIME DEVINS LCSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2017
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 TALCOTTVILLE RD
VERNON CT
06066-4641
US

IV. Provider business mailing address

PO BOX 199
POQUONOCK CT
06064-0199
US

V. Phone/Fax

Practice location:
  • Phone: 207-305-0074
  • Fax: 207-480-7042
Mailing address:
  • Phone: 207-305-0074
  • Fax: 207-480-7042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number122017
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089.0134610
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC17770
License Number StateME
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14209
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: