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NPI 1790081776

NPI 1790081776 : JENNIFER ANN CHOKAS LCSW : WAUREGAN, CT

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General NPI Number Information
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    NPI Number           |    1790081776
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    Entity Type          |    Individual 
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    Provider Name        |    JENNIFER ANN CHOKAS LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/08/2011
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    Last Update Date     |    04/12/2022
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Provider Practice Location Address
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    Address Line         |    19 SOUTH WALNUT ST 530
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    City                 |    WAUREGAN
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    State                |    CT
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    Zip                  |    06387-0530
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    Country              |    US
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    Telephone            |    860-960-0010
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    Fax                  |    860-960-0020
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Provider Business Mailing Address
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    Address Line         |    PO BOX 530 
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    City                 |    WAUREGAN
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    State                |    CT
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    Zip                  |    06387
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    Country              |    US
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    Telephone            |    860-960-0010
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    Fax                  |    860-960-0020
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    005973
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    License Number State |    CT
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