| Jyg Counseling Services, Llc | |
|
252 James St Fairfield CT 06824-6475 | |
| (917) 623-7765 | |
| Not Available |
| Full Name | Jyg Counseling Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 252 James St, Fairfield, Connecticut |
| Authorized Official Name and Position | Jessica Yael Goodman (MANAGING MEMBER) |
| Authorized Official Contact | 9176237765 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jyg Counseling Services, Llc 252 James St Fairfield CT 06824-6475 Ph: (917) 623-7765 | Jyg Counseling Services, Llc 252 James St Fairfield CT 06824-6475 Ph: (917) 623-7765 |
| NPI Number | 1598138398 |
|---|---|
| Provider Enumeration Date | 11/03/2015 |
| Last Update Date | 11/03/2015 |
| Medicare PECOS PAC ID | 2860796703 |
|---|---|
| Medicare Enrollment ID | O20210322000174 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598138398 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 007879 (Connecticut) | Primary |
| Provider Name | Jessica Yael Goodman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295053908 PECOS PAC ID: 3779887617 Enrollment ID: I20210322000266 |
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