Individual
JODI LYNN PECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
280 SOUTH MAIN STREET, SUITE 102, CHESHIRE, CT 06410
(860) 870-6385
(203) 250-0191
Mailing address
P. O. BOX 415933, HARTFORD HOSPITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006608
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004040614
—
CT
Enumeration date
01/10/2007
Last updated
07/19/2022
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