Provider Demographics
NPI:1891740221
Name:JEWISH FAMILY SERVICES OF GREATER HARTFORD
Entity Type:Organization
Organization Name:JEWISH FAMILY SERVICES OF GREATER HARTFORD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:HANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:860-761-7087
Mailing Address - Street 1:333 BLOOMFIELD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1544
Mailing Address - Country:US
Mailing Address - Phone:860-236-1927
Mailing Address - Fax:860-236-6483
Practice Address - Street 1:333 BLOOMFIELD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-1544
Practice Address - Country:US
Practice Address - Phone:860-236-1927
Practice Address - Fax:860-236-6483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004083672Medicaid
CTC01422Medicare PIN