Jacqueline Alexandra Balarezo, MA MENTAL HEALTH
Individual provider Active NPI Mental Health Counselor · Stratford, CT
NPI 1124718259 · NPPES record last updated Jun 13, 2023
Key facts
- NPI
- 1124718259
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 100 Tomlinson PL
Stratford, CT 06614-3062 - Phone
- (203) 543-0142
- NPI assigned
- May 11, 2023
- 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)
- No
- Credentials
- Master of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
100 Tomlinson PL
Stratford, CT 06614-3062
Mailing address
100 Tomlinson PL
Stratford, CT 06614-3062
Phone (203) 543-0142
Other providers in Stratford, CT
- John Clarence Berin Baas
- Back to Health Chiropractic of Stratford PC
- Back to Health Medical Center, P.C.
- Katherine Bajda
- Balanced Behavioral Health, LLC
- Philip Barasch
- Kalyn Bard
- Hope R Baxter
- Lawrence Beck
- Andrew Bedford
All providers in Stratford, CT · Mental Health Counselor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.