Provider Demographics
NPI:1972087823
Name:FAULKNER-FILOSA, JENNA DANIELLE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:DANIELLE
Last Name:FAULKNER-FILOSA
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:DANIELLE
Other - Last Name:WEINBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:45 GROVE ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-6217
Mailing Address - Country:US
Mailing Address - Phone:203-623-2507
Mailing Address - Fax:
Practice Address - Street 1:800 HOWARD AVE FL 1
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1369
Practice Address - Country:US
Practice Address - Phone:203-444-7519
Practice Address - Fax:203-785-4194
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT90571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical