Jenna Marie Nadeau Camerota, LCSW

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

License

12153 Issued in CT

Practice address

300 Church St
Wallingford, CT 06492-2253

Phone

(203) 980-2079

NPI assigned

Apr 26, 2022

Last updated

Apr 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1114661071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 ROUTE 81",
            "city": "KILLINGWORTH",
            "state": "CT",
            "postal_code": "064191240",
            "telephone_number": "203-980-2079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CHURCH ST",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922253",
            "telephone_number": "203-980-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMEROTA",
        "first_name": "JENNA",
        "middle_name": "MARIE NADEAU",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CT",
            "license": "12153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Group Psychotherapy Psychologist in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Group Psychotherapy Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.