Jennifer B Staehly LCSW LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

JENNIFER B STAEHLY LCSW LLC

Practice address

276 S Main St
Colchester, CT 06415-2952

Phone

(860) 575-9891

NPI assigned

Oct 23, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer B Staehly, LCSWNPI 1215325097

Title

Therapist

Phone

(860) 575-9891

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

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

• Jennifer Staehly, LCSW

  • Clinical Social Worker
  • Colchester, CT
  • NPI 1215325097
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540252800000",
    "number": "1710453220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 TOWN ST",
            "city": "EAST HADDAM",
            "state": "CT",
            "postal_code": "064231425",
            "telephone_number": "860-575-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 S MAIN ST",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "064152952",
            "telephone_number": "860-575-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER B STAEHLY LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-23",
        "status": "A",
        "authorized_official_last_name": "STAEHLY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "860-575-9891",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brian P Hurt, DMD
• Catherine Elisabeth Hylwa, M.D.
• Inner Insight Counseling, LLC
• JD Nutrition LLC
• Kara Lynn Jepson, PT
• Jodi Rabinowitz LLC
• Julie Karena Jones, PH.D., LPC
• Erin Curran Kaiser, MA, CCC-SLP
• Wendy R Kane, R.D.N., C.D.C.E.S

• Community/Behavioral Health Agency in Colchester, CT
• Providers in Colchester, CT by specialty
• Community/Behavioral Health Agency in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.