Provider Demographics
NPI:1083030019
Name:JACQUELINE MCNAMEE, LMFT
Entity Type:Organization
Organization Name:JACQUELINE MCNAMEE, LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNAMEE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-815-9214
Mailing Address - Street 1:36 N MAIN ST
Mailing Address - Street 2:2ND FL, UNIT 3
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-3733
Mailing Address - Country:US
Mailing Address - Phone:203-815-9214
Mailing Address - Fax:
Practice Address - Street 1:40 DEER RUN RD
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-3306
Practice Address - Country:US
Practice Address - Phone:203-815-9214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001403106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty