Organization
JONATHAN STERN, M.S., L.P.C., L.A.D.C., COUNSELING AND PSYCHOTHERAPY S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN DAVID STERN L.P.C., L.A.D.C. (OWNER)
(203) 213-9987
Entity
Organization
Contact information
Practice address
2911 DIXWELL AVE, SUITE B-5, HAMDEN, CT 06518-3195
(203) 916-5496
(203) 265-1216
Mailing address
2911 DIXWELL AVE, SUITE B-5, HAMDEN, CT 06518-3195
(203) 916-5496
(203) 265-1216
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
000823
CT
251S00000X
Community/Behavioral Health Agency
Primary
001882
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235918
—
CT
01
—
1018781
CIGNA PROVIDER ID
CT
01
—
12094074
CAQH
CT
Enumeration date
03/26/2013
Last updated
03/26/2013
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