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Jazzmine Sue Carrillo
Addiction (Substance Use Disorder) Counselor in Groton, Connecticut
NPI 1790546059

Jazzmine Sue Carrillo is an Addiction (Substance Use Disorder) Counselor based in Groton, CT and is specialized in Addiction (Substance Use Disorder). Jazzmine Sue Carrillo practices in Groton, CT. The NPI Number for Jazzmine Sue Carrillo is 1790546059 and holds a License No. 1539 (Connecticut).

The current practice location address for Jazzmine Sue Carrillo is 85 Crouch St Apt 15, Groton, CT and can be reached out via phone at 860-514-5695. You can also correspond with Jazzmine Sue Carrillo through the mailing address at 85 CROUCH ST APT 15, GROTON, CT - 06340-3759 (mailing address contact number: 860-514-5695).

Location: 85 Crouch St Apt 15, Groton, CT, 06340-3759
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1790546059
Provider Name
Jazzmine Sue Carrillo
Credential
Provider Entity Type
Individual
Gender
Female
Address
85 Crouch St Apt 15, Groton, CT, 06340-3759
Phone Number
860-514-5695
Fax Number
Provider Enumeration Date
01/23/2024
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
85 Crouch St Apt 15
City
Groton
State
Connecticut
Zip
06340-3759
Phone Number
860-514-5695
Fax Number
person
Provider Business Mailing Address Details
Address
85 Crouch St Apt 15
City
Groton
State
Connecticut
Zip
06340-3759
Phone Number
860-514-5695
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
1539 (Connecticut)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
1539 (Connecticut)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
1539 ()
Definition
Definition to come...
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