Provider Demographics
NPI:1184179798
Name:DEMAYO, JENNIFER (NCC, LMHC, LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DEMAYO
Suffix:
Gender:F
Credentials:NCC, LMHC, LPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:LJUNGQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NCC, LMHC, LPC
Mailing Address - Street 1:1204 MAIN ST # 772
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3787
Mailing Address - Country:US
Mailing Address - Phone:860-264-5565
Mailing Address - Fax:
Practice Address - Street 1:1 ENTERPRISE DR STE 420
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4779
Practice Address - Country:US
Practice Address - Phone:860-264-5565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor