Provider Demographics
NPI:1235434085
Name:ALEJANDRO, JESSICA (LMFT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ALEJANDRO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 SLATER RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053
Mailing Address - Country:US
Mailing Address - Phone:860-680-5238
Mailing Address - Fax:
Practice Address - Street 1:6 WAY RD
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06455-1080
Practice Address - Country:US
Practice Address - Phone:860-680-5238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001435106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist