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General NPI Number Information
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NPI Number | 1356715759
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Entity Type | Individual
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Provider Name | JESSICA LABARCA MA, ATR-BC, LPC
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Gender | Female
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 30 BRIDGE ST
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City | NEW MILFORD
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State | CT
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Zip | 06776-3517
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Country | US
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Telephone | 484-576-7885
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Fax |
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Provider Business Mailing Address
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Address Line | 1 BUCKINGHAM RD
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City | NEW MILFORD
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State | CT
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Zip | 06776-2201
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Country | US
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Telephone | 484-576-7885
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 005494
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC008652
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License Number State | PA
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