Organization
JESSICA VIVENZIO, LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA VIVENZIO LCSW (LLC OWNER)
(413) 531-5788
Entity
Organization
Contact information
Practice address
68 HOPE ST APT 11, STAMFORD, CT 06906-2607
(413) 531-5788
Mailing address
68 HOPE ST APT 11, STAMFORD, CT 06906-2607
(413) 531-5788
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
02/01/2022
Last updated
02/14/2022
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