Jacquelynn Russo-Boudinot, LMFT, NCC, CDM
Marriage & Family Therapist in Centerbrook, Connecticut
1538521927- Practice location
- 90 Main St Ste 103A, Centerbrook, CT 06409-1057
- Phone
- 860-510-6130
- Fax
- 860-760-6706
- Last updated
- January 18, 2024
Jacquelynn Russo-Boudinot is a Marriage & Family Therapist based in Centerbrook, CT. Jacquelynn Russo-Boudinot practices in Centerbrook, CT and has the professional credentials of LMFT, NCC, CDM. The NPI Number for Jacquelynn Russo-Boudinot is 1538521927 and holds a License No. 1806 (CT). The current practice location address for Jacquelynn Russo-Boudinot is 90 Main St Ste 103A, Centerbrook, CT 06409-1057 and can be reached out via phone at 860-510-6130 and via fax at 860-760-6706.
Provider Profile Details
- NPI Number
- 1538521927
- Provider Name
- Jacquelynn Russo-Boudinot
- Credential
- LMFT, NCC, CDM
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 90 Main St Ste 103A, Centerbrook, CT 06409-1057
- Phone Number
- 860-510-6130
- Fax Number
- 860-760-6706
- Primary Taxonomy
- Marriage & Family Therapist · 106H00000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- March 24, 2016
- Last Update Date
- January 18, 2024
- Certification Date
- January 18, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 90 Main St Ste 103A
Centerbrook, CT 06409-1057 - City
- Centerbrook
- State
- Connecticut
- Zip
- 06409-1057
- Phone Number
- 860-510-6130
- Fax Number
- 860-760-6706
Provider Business Mailing Address Details
- Address
- 90 Main St Ste 103A
Centerbrook, CT 06409-1057 - City
- Centerbrook
- State
- CT
- Zip
- 06409-1057
- Phone Number
- 860-510-6130
- Fax Number
- 860-760-6706
License Information
- Taxonomy (1)
- Counselor, Mental Health · 101YM0800X
- Taxonomy (2)
- Counselor, Professional · 101YP2500X
- License Number (3)
- 1806
- License State (3)
- CT
- Taxonomy (3)
- Marriage & Family Therapist · 106H00000X · Primary
- Taxonomy (4)
- Marriage & Family Therapist · 106H00000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Jacquelynn Russo-Boudinot, LMFT, NCC, CDM?
The NPI number of Jacquelynn Russo-Boudinot, LMFT, NCC, CDM is 1538521927. It was assigned on March 24, 2016 and is currently active in the NPPES registry.
What is the specialty of Jacquelynn Russo-Boudinot, LMFT, NCC, CDM?
Jacquelynn Russo-Boudinot, LMFT, NCC, CDM is registered under the primary taxonomy Marriage & Family Therapist (code 106H00000X), licensed in CT under license number 1806.
Where does Jacquelynn Russo-Boudinot, LMFT, NCC, CDM practice?
The practice location is 90 Main St Ste 103A, Centerbrook, CT 06409-1057. The office can be reached at 860-510-6130 (phone) or 860-760-6706 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1538521927 directly on the NPPES registry website.