Individual
MR. JEFFREY R CORNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW,BA,LMSW
Contact information
Practice address
141 E MAIN ST, WATERBURY CLINICAL SERVICES 2ND FLOOR, WATERBURY, CT 06702-2310
(203) 756-7287
(203) 596-0722
Mailing address
141 E MAIN ST, 4TH FLOOR ADMINISTRATION, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1934
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008060097
—
CT
01
—
060669107
HEALTHYCT WELLMORE GRP/FACILITY
CT
01
—
13605884
CAQH
CT
01
—
D339209 WATERBURY
BEACON HEALTH STRATEGIES WELLMORE GRP/FACILITY
CT
01
—
NOT ELIGIBLE
MHN MANAGED HEALTH NETWORK
CT
01
—
PENDING
AETNA BEHAVIORAL HEALTH
CT
Enumeration date
07/17/2012
Last updated
08/25/2016
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