person
Miss Jennifer Lyne Decosmo, LPC
Professional Counselor in Wallingford, Connecticut
NPI 1649587924

Jennifer Lyne Decosmo is a Professional Counselor based in Wallingford, CT and is specialized in Professional. Jennifer Lyne Decosmo practices in Wallingford, CT and has the professional credentials of LPC. The NPI Number for Jennifer Lyne Decosmo is 1649587924 and holds a License No. 001917 (Connecticut).

The current practice location address for Jennifer Lyne Decosmo is 380 Main St, Wallingford, CT and can be reached out via phone at 203-575-0466 and via fax at 203-575-1817. You can also correspond with Jennifer Lyne Decosmo through the mailing address at 380 MAIN ST, WALLINGFORD, CT - 06492-2281 (mailing address contact number: 203-575-0466).

Location: 380 Main St, Wallingford, CT, 06492-2281
person
Provider Profile Details
NPI Number
1649587924
Provider Name
Jennifer Lyne Decosmo
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
380 Main St, Wallingford, CT, 06492-2281
Phone Number
203-575-0466
Fax Number
203-575-1817
Provider Enumeration Date
09/08/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
08037449 05 CT
institution
Provider Business Practice Location Address Details
Address
380 Main St
City
State
Zip
06492-2281
Phone Number
203-575-0466
Fax Number
203-575-1817
person
Provider Business Mailing Address Details
Address
380 Main St
City
State
Zip
06492-2281
Phone Number
203-575-0466
Fax Number
203-575-1817
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
001917 (Connecticut)
Definition
Definition to come...
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