Provider Demographics
NPI:1790453306
Name:GETNER, JASEN (JAY) MATTHEW (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JASEN (JAY)
Middle Name:MATTHEW
Last Name:GETNER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 BIRCHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-1049
Mailing Address - Country:US
Mailing Address - Phone:203-515-4755
Mailing Address - Fax:
Practice Address - Street 1:64 BIRCHWOOD RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-1049
Practice Address - Country:US
Practice Address - Phone:203-581-0053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002193106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist