MEDICARE: MRS. JILL MEYERS PAKNIA 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	1041C0700X	Clinical Social Worker	0417341	NY
2	1041C0700X	Clinical Social Worker	006329	CT

General Provider Information

NPI Number	:	1720144538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JILL MEYERS PAKNIA LCSW

Provider Business Mailing Address
First Line	:	202 GOOD HILL RD
Second Line	:
City	:	WESTON
State	:	CT
Zip	:	06883-2326
Country	:	US
Telephone Number	:	203-998-5279
Fax Number	:	866-585-4617

Provider Business Practice Location Address
First Line	:	91 EAST AVE
Second Line	:
City	:	NORWALK
State	:	CT
Zip	:	06851-5020
Country	:	US
Telephone Number	:	203-998-5279
Fax Number	:	866-585-4617

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	10/21/2015

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