Provider Demographics
NPI:1750028031
Name:JENNIFER ANDERSON, LMFT, LLC
Entity Type:Organization
Organization Name:JENNIFER ANDERSON, LMFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:401-837-8703
Mailing Address - Street 1:314 NEW BRITAIN RD STE C
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06037-5306
Mailing Address - Country:US
Mailing Address - Phone:860-266-7558
Mailing Address - Fax:
Practice Address - Street 1:314 NEW BRITAIN RD STE C
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06037-5306
Practice Address - Country:US
Practice Address - Phone:860-266-7558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty