Provider Demographics
NPI:1326488503
Name:CAPALBO, JENNFIER ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNFIER
Middle Name:ANN
Last Name:CAPALBO
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 1:9 TURKEY HOLW
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06057-2743
Mailing Address - Country:US
Mailing Address - Phone:978-621-2771
Mailing Address - Fax:
Practice Address - Street 1:28 SAINT JOHN PL
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-5437
Practice Address - Country:US
Practice Address - Phone:860-459-6777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0060191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical