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General NPI Number Information
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NPI Number | 1629466354
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Entity Type | Organization
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Legal Business Name | JENNIFER M. LOMBARDI, LCSW, LLC
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 45 S MAIN ST SUITE 107
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City | WEST HARTFORD
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State | CT
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Zip | 06107-2441
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Country | US
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Telephone | 860-532-5109
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Fax |
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Provider Business Mailing Address
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Address Line | 39 BREWSTER RD APT D
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City | GLASTONBURY
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State | CT
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Zip | 06033-1046
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Country | US
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Telephone | 860-532-5109
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER MARIE LOMBARDI
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Credential | LCSW
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Telephone | 860-532-5109
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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 | 007852
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License Number State | CT
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