Jazzmine S Carrillo
Counselor, Addiction (Substance Use Disorder) in Groton, Connecticut
1790546059- Practice location
- 85 Crouch St Apt 15, Groton, CT 06340-3759
- Phone
- 860-514-5695
- Fax
- —
- Last updated
- January 23, 2024
Jazzmine Sue Carrillo is a Counselor, Addiction (Substance Use Disorder) based in Groton, CT. Jazzmine Sue Carrillo practices in Groton, CT. The NPI Number for Jazzmine Sue Carrillo is 1790546059 and holds a License No. 1539. The current practice location address for Jazzmine Sue Carrillo is 85 Crouch St Apt 15, Groton, CT 06340-3759 and can be reached out via phone at 860-514-5695.
Provider Profile Details
- NPI Number
- 1790546059
- Provider Name
- Jazzmine Sue Carrillo
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 85 Crouch St Apt 15, Groton, CT 06340-3759
- Phone Number
- 860-514-5695
- Primary Taxonomy
- Counselor, Addiction (Substance Use Disorder) · 101YA0400X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- January 23, 2024
- Last Update Date
- January 23, 2024
- Certification Date
- January 23, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 85 Crouch St Apt 15
Groton, CT 06340-3759 - City
- Groton
- State
- Connecticut
- Zip
- 06340-3759
- Phone Number
- 860-514-5695
Provider Business Mailing Address Details
- Address
- 85 Crouch St Apt 15
Groton, CT 06340-3759 - City
- Groton
- State
- CT
- Zip
- 06340-3759
- Phone Number
- 860-514-5695
License Information
- License Number (1)
- 1539
- Taxonomy (1)
- Counselor · 101Y00000X
- License Number (2)
- 1539
- License State (2)
- CT
- Taxonomy (2)
- Counselor, Mental Health · 101YM0800X
- License Number (3)
- 1539
- License State (3)
- CT
- Taxonomy (3)
- Counselor, Addiction (Substance Use Disorder) · 101YA0400X · Primary
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 Jazzmine S Carrillo?
The NPI number of Jazzmine S Carrillo is 1790546059. It was assigned on January 23, 2024 and is currently active in the NPPES registry.
What is the specialty of Jazzmine S Carrillo?
Jazzmine S Carrillo is registered under the primary taxonomy Counselor, Addiction (Substance Use Disorder) (code 101YA0400X), licensed under license number 1539.
Where does Jazzmine S Carrillo practice?
The practice location is 85 Crouch St Apt 15, Groton, CT 06340-3759. The office can be reached at 860-514-5695 (phone).
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 1790546059 directly on the NPPES registry website.