Provider Demographics
NPI:1538525282
Name:SETARO, JENNIE
Entity type:Individual
Prefix:MRS
First Name:JENNIE
Middle Name:
Last Name:SETARO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 KING ARTHUR CT
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-1006
Mailing Address - Country:US
Mailing Address - Phone:203-303-4988
Mailing Address - Fax:
Practice Address - Street 1:10 KING ARTHUR CT
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-1006
Practice Address - Country:US
Practice Address - Phone:203-303-4988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-11
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health