Amanda Jelden, LCSW
Individual provider Active NPI Clinical Social Worker · Ledyard, CT
NPI 1801338488 · NPPES record last updated Jan 7, 2022
Key facts
- NPI
- 1801338488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 9625 (CT)
- Practice address
- 5 Lorenz Industrial Pkwy
Ledyard, CT 06339-1946 - Phone
- (860) 892-7042
- NPI assigned
- Nov 14, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9625 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glow Up Therapy | Clinical | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 9625 | CT | Yes |
Addresses
Primary practice location
5 Lorenz Industrial Pkwy
Ledyard, CT 06339-1946
Mailing address
5 Lorenz Industrial Pkwy
Ledyard, CT 06339-1946
Phone (860) 892-7042
Other providers in Ledyard, CT
- Joanne Helen Gauthier
- Kristina Georgian
- Jay Clark Hans
- Healing Within Therapy LLC
- Home Aid of CT Inc
- Kristine Johnson
- Rosemary Johnson
- Joy Holistic Counseling LLC
- Michael Christopher Kendig
- Taylor Kilen
All providers in Ledyard, CT · Clinical Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2022. 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.