Individual
MRS. JILL CATHERINE HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, NBCC, MS,BA
Contact information
Practice address
141 E MAIN ST, WELLMORE INC-3RD FLOOR, WATERBURY, CT 06702-2310
(203) 575-0456
(203) 575-1817
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
101YP2500X
Professional Counselor
Primary
001348
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008037434
—
CT
01
—
060669107
UBH-CONNECTICARE WELLMORE GRP/FACILITY
CT
01
—
13540256
CAQH
CT
01
—
4687873
CIGNA BEHAVIORAL HEALTH
CT
01
—
539524
MHN MANAGED HEALTHCARE
CT
01
—
539524 PENDING
MHN TRICARE NORTH
CT
01
—
9403704
AETNA BEHAVIORAL HEALTH
CT
01
—
D339123 141 E MAIN
BEACON HEALTH STRATEGIES
CT
01
—
NBCC-62197
NATIONAL BOARD OF CERTIFIED COUNSELORS
CT
Enumeration date
11/07/2008
Last updated
05/11/2016
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