Provider Demographics
NPI:1255827317
Name:JENNY E. NOIA-GILSON, LCSW, PLLC
Entity Type:Organization
Organization Name:JENNY E. NOIA-GILSON, LCSW, PLLC
Other - Org Name:JENNY NOIA-GILSON, LCSW
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:NOIA-GILSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-231-2043
Mailing Address - Street 1:415 HOWE AVE STE 193
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-3168
Mailing Address - Country:US
Mailing Address - Phone:203-231-2043
Mailing Address - Fax:
Practice Address - Street 1:415 HOWE AVE STE 193
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-3168
Practice Address - Country:US
Practice Address - Phone:203-231-2043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00075921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1902227077OtherNPI