Jennifer T Bethea, LADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · North Haven, CT

NPI 1306385802 · NPPES record last updated Jun 25, 2026

Key facts

NPI
1306385802
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
1672 (CT)
Practice address
352 State St
North Haven, CT 06473-3108
Phone
(203) 781-4600
Fax
(203) 781-4624
NPI assigned
Feb 16, 2017
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1672CTMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1672 CT Yes

Addresses

Primary practice location

352 State St
North Haven, CT 06473-3108

Mailing address

1 Long Wharf Dr Ste 321
New Haven, CT 06511-5946
Phone (203) 781-4600

Other practice location 1

127 W 25th St
New York, NY 10001-7207
Phone (212) 529-6320 ext. 8726

Other identifiers

IdentifierTypeStateIssuer
004082286MedicaidCT
008144778MedicaidCT
008022626MedicaidCT
500000315MedicaidCT
008056168MedicaidCT

Other providers in North Haven, CT

All providers in North Haven, CT · Addiction (Substance Use Disorder) Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.