Provider Demographics
NPI:1790835478
Name:NOEL, JAYNE M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JAYNE
Middle Name:M
Last Name:NOEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:JAYNE
Other - Middle Name:M
Other - Last Name:WEBBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS
Mailing Address - Street 1:95 RAFFIA ROAD
Mailing Address - Street 2:SUITE # 2
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082
Mailing Address - Country:US
Mailing Address - Phone:860-623-4523
Mailing Address - Fax:860-749-9298
Practice Address - Street 1:95 RAFFIA ROAD
Practice Address - Street 2:KIDZ MATTER LLC SUITE # 2
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082
Practice Address - Country:US
Practice Address - Phone:860-749-9298
Practice Address - Fax:860-749-9298
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0042531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical