Organization Active NPI

JLB Therapy LLC

  • Adult Mental Health Clinic/Center
  • Madison, CT
National Provider Identifier
1053181248
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
JLB THERAPY LLC
Practice address
762 Boston Post Rd
Madison, CT 06443-3047
Phone
(860) 575-3491
NPI assigned
Jan 8, 2024
Last updated
Jan 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Janel Lynch Bacon, LMFT
Title
Owner
Phone
(860) 575-3491

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary

Addresses

Primary practice location

762 Boston Post Rd
Madison, CT 06443-3047

Mailing address

47 Oakwood Dr
Madison, CT 06443-1823
Phone (860) 575-3491

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1053181248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 OAKWOOD DR",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064431823",
            "telephone_number": "860-575-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 BOSTON POST RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433047",
            "telephone_number": "860-575-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JLB THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "BACON",
        "authorized_official_first_name": "JANEL",
        "authorized_official_middle_name": "LYNCH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-575-3491",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.