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NPI Code Detail

MEDICARE: JENNIFER ANN GRANT LCSW

MEDICARE: JENNIFER ANN GRANT 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
11041C0700XClinical Social Worker006166CT

General Provider Information

NPI Number : 1841325867
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER ANN GRANT LCSW
Provider Business Mailing Address
First Line : 550 GOSHEN RD
Second Line :
City : LITCHFIELD
State : CT
Zip : 06759-2405
Country : US
Telephone Number : 860-567-9423
Fax Number : 860-567-3479
Provider Business Practice Location Address
First Line : 550 GOSHEN RD
Second Line :
City : LITCHFIELD
State : CT
Zip : 06759-2405
Country : US
Telephone Number : 860-567-9423
Fax Number : 860-567-3479
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 12/30/2013

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