Provider Demographics
NPI:1740792696
Name:DUDAS, JACQUELINE EVE (MS, NCC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:EVE
Last Name:DUDAS
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 WEST ST
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6529
Mailing Address - Country:US
Mailing Address - Phone:203-748-2936
Mailing Address - Fax:
Practice Address - Street 1:91 WEST ST
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6529
Practice Address - Country:US
Practice Address - Phone:203-748-2936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3309101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health