Provider Demographics
NPI:1770813669
Name:JONES, JANNET (LADC)
Entity Type:Individual
Prefix:MRS
First Name:JANNET
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:4TH FLOOR ADMINISTRATION
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-2310
Mailing Address - Country:US
Mailing Address - Phone:203-574-9000
Mailing Address - Fax:203-574-9006
Practice Address - Street 1:402 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1701
Practice Address - Country:US
Practice Address - Phone:203-574-9000
Practice Address - Fax:203-574-9006
Is Sole Proprietor?:No
Enumeration Date:2009-12-28
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060669107OtherHEALTHYCT WELLMORE GRP/FACILITY
CT060669107OtherCONNECTICARE/UBH WELLMORE GRP/FACILITY
CT060669107OtherOPTUM BEHAVIORAL HEALTH/UBH WELLMORE GRP/FACILITY
CT060669107OtherUNITED HEALTHCARE/UBH WELLMORE GRP/FACILITY
CT060669107OtherOXNARD/FREEDOM LIBERTY/UBH WELLMORE GRP/FACILITY
CTPENDINGOtherCIGNA BEHAVIORAL HEALTH
CT060669107OtherAETNA BEHAVIORAL HEALTH
CTNOT ELIGIBLEOtherMHN MANAGED HEALTH NETWORK
CT060669107OtherANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CTNOT ELIGIBLEOtherMHN TRICARENORTH
CT004039202Medicaid
CT13528679OtherCAQH
CT004039202Medicaid