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General NPI Number Information
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NPI Number | 1316862337
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Entity Type | Organization
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Legal Business Name | CONNECTICUT PSYCHTHERAPY
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Dates
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Enumeration Date | 08/11/2026
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Last Update Date | 08/11/2026
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Provider Practice Location Address
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Address Line | 17 BRIDGE SQ
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City | WESTPORT
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State | CT
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Zip | 06880-5901
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Country | US
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Telephone | 646-470-1786
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Fax |
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Provider Business Mailing Address
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Address Line | 382 HIGH RIDGE DR
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City | BRIDGEPORT
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State | CT
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Zip | 06606-4969
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | JACQUELINE NOEMI JIMENEZ
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Credential | LMSW
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Telephone | 227-213-3758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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