MEDICARE: JENNIFER M SPIRITO LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	006589	CT
2	1041C0700X	Clinical Social Worker	006589	CT

General Provider Information

NPI Number	:	1548408610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER M SPIRITO LCSW

Provider Business Mailing Address
First Line	:	244 TOWN LINE RD
Second Line	:
City	:	BRISTOL
State	:	CT
Zip	:	06010-5914
Country	:	US
Telephone Number	:	860-628-1675
Fax Number	:

Provider Business Practice Location Address
First Line	:	61 S MAIN ST STE 310
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06107-2403
Country	:	US
Telephone Number	:	860-628-1675
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2009
Last Update Date	:	12/29/2022

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