Healthcare Provider Details

I. General information

NPI: 1427476324
Provider Name (Legal Business Name): JODIE SEMEL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2014
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 POST ROAD WEST
WESTPORT CT
06880
US

IV. Provider business mailing address

16A REDCOAT RD
WESTPORT CT
06880
US

V. Phone/Fax

Practice location:
  • Phone: 203-984-2164
  • Fax: 203-373-0835
Mailing address:
  • Phone: 203-984-2162
  • Fax: 203-373-0835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2947
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: