Jacquelynn Russo-boudinot, LMFT, NCC, CDM is a
Marriage & Family Therapist based in Centerbrook, Connecticut. Jacquelynn Russo-boudinot is licensed to practice in Connecticut (license number 1806) and her current practice location is
90 Main St Ste 103a, Centerbrook, Connecticut. She can be reached at her office (for appointments etc.) via phone at
(860) 510-6130.
NPI number for Jacquelynn Russo-boudinot is 1538521927 and her current mailing address is 90 Main St Ste 103a, Centerbrook, Connecticut. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1538521927.
Healthcare Provider's Profile
| Full Name | Jacquelynn Russo-boudinot |
|---|
| Gender | Female |
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| Speciality | Marriage & Family Therapist |
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| Location | 90 Main St Ste 103a, Centerbrook, Connecticut |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1538521927
- Provider Enumeration Date: 03/24/2016
- Last Update Date: 01/18/2024
Medical Identifiers
Medical identifiers for Jacquelynn Russo-boudinot such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538521927 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | 1806 (Connecticut) | Primary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacquelynn Russo-boudinot is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jacquelynn Russo-boudinot, LMFT, NCC, CDM
90 Main St Ste 103a,
Centerbrook, CT 06409-1057
Ph: (860) 510-6130 | Jacquelynn Russo-boudinot, LMFT, NCC, CDM
90 Main St Ste 103a,
Centerbrook, CT 06409-1057
Ph: (860) 510-6130 |
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