Provider Demographics
NPI:1881830032
Name:PYRCH, JENNIFER V (MSW,, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:V
Last Name:PYRCH
Suffix:
Gender:F
Credentials:MSW,, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 WOOLAM RD
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06088-9723
Mailing Address - Country:US
Mailing Address - Phone:860-281-4395
Mailing Address - Fax:
Practice Address - Street 1:192 HARTFORD RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-5923
Practice Address - Country:US
Practice Address - Phone:860-281-4395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0067941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT006794OtherSTATE OF CT LICENSE 006794, VALIDATION # 03-683870