Individual
MS. JAIME PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
400 COLUMBUS AVE, ADULT PSYCHIATRIC CLINIC, NEW HAVEN, CT 06519-1233
(203) 503-3075
(203) 503-3296
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
104100000X
Social Worker
—
CT
1041C0700X
Clinical Social Worker
Primary
009588
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235918
—
CT
Enumeration date
06/03/2014
Last updated
07/07/2020
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