Individual
JENNA NICOLE TOMASIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24 CHIMNEY DR, BETHEL, CT 06801-1225
(845) 905-6564
Mailing address
24 CHIMNEY DR, BETHEL, CT 06801-1225
(845) 905-6564
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
103149
NY
1041C0700X
Clinical Social Worker
Primary
4373
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02995857
—
NY
01
—
1497737167
AGENCY NPI
NY
Enumeration date
10/17/2019
Last updated
10/18/2023
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