Provider Demographics
NPI:1902227077
Name:NOIA-GILSON, JENNY E (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:E
Last Name:NOIA-GILSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:NOIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:48 SULTAN ST
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-2721
Mailing Address - Country:US
Mailing Address - Phone:203-231-2043
Mailing Address - Fax:203-283-7062
Practice Address - Street 1:48 SULTAN ST
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-2721
Practice Address - Country:US
Practice Address - Phone:203-231-2043
Practice Address - Fax:203-283-7062
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT75921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical