Southwindsorpsychotherapy

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SOUTHWINDSORPSYCHOTHERAPY

Practice address

1169 Ellington Rd
South Windsor, CT 06074-3515

Phone

(860) 978-5916

NPI assigned

May 9, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Timothy J Jeski, LCSWNPI 1891980678

Title

Licensed Clinical Social Worker

Phone

(860) 324-2840

Specialties & licenses 1

Addresses

Other names 1

• Timothy Jeski, LCSW Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy James Jeski, LCSW

  • Social Worker
  • South Windsor, CT
  • NPI 1891980678
  NPD Authorized official

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1275279697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 MAIN ST",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061112413",
            "telephone_number": "860-978-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 ELLINGTON RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743515",
            "telephone_number": "860-978-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWINDSORPSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-09",
        "last_updated": "2022-05-09",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "JESKI",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "860-324-2840",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Timothy Jeski, LCSW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Windsor Ambulatory Care Ctr Inc
• South Windsor Board of Education
• South Windsor Neck and Back, LLC
• South Windsor Pediatrics, LLC
• South Windsor Perio, PLLC
• Rose M Spada
• Wendy Sperry, FNP
• Tanya Anne Spiller, RPH
• Stacy Joanne Spiro, MD
• Sportsmedicine Partners, Orthopedics & Rehabilitation Therapy, P.C.

• Mental Health Clinic/Center (Including Community Mental Health Center) in South Windsor, CT
• Providers in South Windsor, CT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.