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General NPI Number Information
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NPI Number | 1366919722
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Entity Type | Individual
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Provider Name | JILLIAN BEDNARZ LMHC
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Gender | Female
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Dates
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Enumeration Date | 10/24/2018
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | 800 WINCHESTER AVE FL 2
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City | NEW HAVEN
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State | CT
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Zip | 06511-1131
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Country | US
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Telephone | 617-545-5233
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Fax | 917-732-7755
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Provider Business Mailing Address
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Address Line | 800 WINCHESTER AVE FL 2
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City | NEW HAVEN
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State | CT
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Zip | 06511-1131
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Country | US
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Telephone | 617-545-5233
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Fax | 917-732-7755
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 008968
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License Number State | NY
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