Healthcare Provider Details

I. General information

NPI: 1740905983
Provider Name (Legal Business Name): JESSICA DEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1127 W MAIN ST
WATERBURY CT
06708-2764
US

IV. Provider business mailing address

1127 W MAIN ST
WATERBURY CT
06708-2764
US

V. Phone/Fax

Practice location:
  • Phone: 860-325-9245
  • Fax:
Mailing address:
  • Phone: 860-325-9245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number96
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number007938
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: