Individual
DR. JEFFREY WARREN SUMMERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D., LCSW
Contact information
Practice address
295 WASHINGTON AVENUE, SUITE 9, HAMDEN, CT 06518-3025
(203) 287-8227
(203) 287-9502
Mailing address
295 WASHINGTON AVENUE, SUITE 9, HAMDEN, CT 06518-3025
(203) 287-8227
(203) 287-9502
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000823
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140000823CT01
ANTHEM BCBS
—
Enumeration date
08/05/2006
Last updated
02/14/2012
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