Provider Demographics
NPI:1003920588
Name:COSCIA, JENNIFER J (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:J
Last Name:COSCIA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:J
Other - Last Name:PENSIERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:49 PETER ROAD
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-2681
Mailing Address - Country:US
Mailing Address - Phone:203-586-9994
Mailing Address - Fax:
Practice Address - Street 1:49 PETER ROAD
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-2681
Practice Address - Country:US
Practice Address - Phone:203-586-9994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT00734106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist