| Jo-ellen Hubelbank, Lcsw, Llc | |
|
114 S Main St Suite 28 Cheshire CT 06410-3111 | |
| (203) 288-0242 | |
| Not Available |
| Full Name | Jo-ellen Hubelbank, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 114 S Main St, Cheshire, Connecticut |
| Authorized Official Name and Position | Jo-ellen Hubelbank (PSYCHOTHERAPIST) |
| Authorized Official Contact | 2032880242 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jo-ellen Hubelbank, Lcsw, Llc 114 S Main St Suite 28 Cheshire CT 06410-3111 Ph: (203) 288-0242 | Jo-ellen Hubelbank, Lcsw, Llc 114 S Main St Suite 28 Cheshire CT 06410-3111 Ph: (203) 288-0242 |
| NPI Number | 1972980753 |
|---|---|
| Provider Enumeration Date | 04/30/2015 |
| Last Update Date | 08/23/2023 |
| Certification Date | 07/19/2023 |
| Medicare PECOS PAC ID | 3375853336 |
|---|---|
| Medicare Enrollment ID | O20151104001331 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972980753 | NPI | - | NPPES |
| 008058177 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 004193 (Connecticut) | Primary |
| Provider Name | Jo-ellen Hubelbank |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295831022 PECOS PAC ID: 4284944240 Enrollment ID: I20151104001409 |
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