Provider Demographics
NPI:1760004212
Name:AUGER, JENNIFER LANCZYCKI (MSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LANCZYCKI
Last Name:AUGER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 OLD STONE XING
Mailing Address - Street 2:
Mailing Address - City:WEST SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06092-2820
Mailing Address - Country:US
Mailing Address - Phone:860-413-2294
Mailing Address - Fax:
Practice Address - Street 1:21 OLD STONE XING
Practice Address - Street 2:
Practice Address - City:WEST SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06092-2820
Practice Address - Country:US
Practice Address - Phone:860-413-2294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2004104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker