Jennifer Kucharski Baumgold, LCSW

Individual provider Active NPI Clinical Social Worker · Darien, CT

NPI 1013144435 · NPPES record last updated Nov 23, 2016

Key facts

NPI
1013144435
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
006974 (CT)
Practice address
6 Thorndal Cir
Darien, CT 06820-5415
Phone
(646) 320-0695
NPI assigned
Jun 11, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
73078768NYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 006974 CT Yes
Clinical Social Worker 1041C0700X 73078768 NY

Addresses

Primary practice location

6 Thorndal Cir
Darien, CT 06820-5415

Mailing address

6 Thorndal Cir
Darien, CT 06820-5415
Phone (646) 320-0695

Other providers in Darien, CT

All providers in Darien, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.