Provider Demographics
NPI:1851407985
Name:GENNETT, NANCY (LPC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:GENNETT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 HIGHLAND ST
Mailing Address - Street 2:NEW BRITIAN GENERAL HOSPITAL SUBSTANCE ABUSE SERVICES
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-2013
Mailing Address - Country:US
Mailing Address - Phone:860-224-9985
Mailing Address - Fax:860-826-4995
Practice Address - Street 1:33 HIGHLAND ST
Practice Address - Street 2:NEW BRITIAN GENERAL HOSPITAL SUBSTANCE ABUSE SERVICES
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-2013
Practice Address - Country:US
Practice Address - Phone:860-224-9985
Practice Address - Fax:860-826-4995
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000555101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor