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General NPI Number Information
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NPI Number | 1548408610
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Entity Type | Individual
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Provider Name | JENNIFER M SPIRITO LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/28/2009
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Last Update Date | 12/29/2022
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Provider Practice Location Address
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Address Line | 61 S MAIN ST STE 310
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City | WEST HARTFORD
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State | CT
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Zip | 06107-2403
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Country | US
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Telephone | 860-628-1675
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Fax |
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Provider Business Mailing Address
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Address Line | 244 TOWN LINE RD
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City | BRISTOL
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State | CT
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Zip | 06010-5914
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Country | US
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Telephone | 860-628-1675
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 006589
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 006589
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License Number State | CT
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