MEDICARE: JERNE COUNSELING LLC

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
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1851281364
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JERNE COUNSELING LLC

Provider Business Mailing Address
First Line	:	108 WEST ST APT A1
Second Line	:
City	:	ROCKY HILL
State	:	CT
Zip	:	06067-3526
Country	:	US
Telephone Number	:	617-816-9862
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 WEST ST APT A1
Second Line	:
City	:	ROCKY HILL
State	:	CT
Zip	:	06067-3526
Country	:	US
Telephone Number	:	617-816-9862
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHELLA BEAUZIL
Credential	:	LCSW
Telephone Number	:	617-816-9862

Provider Enumeration Date	:	07/07/2025
Last Update Date	:	07/30/2025

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