Provider Demographics
NPI:1184641862
Name:LEDOUX, JODILYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:JODILYNN
Middle Name:
Last Name:LEDOUX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-5047
Mailing Address - Country:US
Mailing Address - Phone:860-482-5558
Mailing Address - Fax:860-489-2984
Practice Address - Street 1:132 GROVE ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-5047
Practice Address - Country:US
Practice Address - Phone:860-482-5558
Practice Address - Fax:860-489-2984
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0052351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical