Individual
DR. JOMARY SEPULVEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
400 COLUMBUS AVE, APC, NEW HAVEN, CT 06519
(203) 503-3673
(203) 503-3600
Mailing address
400 COLUMBUS AVE, CREDENTIALING SPECIALIST, NEW HAVEN, CT 06519-1233
(203) 503-3174
(203) 503-3183
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
3521
CT
103T00000X
Psychologist
Primary
4700
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235918
—
CT
Enumeration date
06/28/2016
Last updated
03/26/2024
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