Provider Demographics
NPI:1972611283
Name:GIUSTRA-KOZEK, JENNIFER (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:GIUSTRA-KOZEK
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 1:787 MAIN ST S UNIT A-5
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06798-3741
Mailing Address - Country:US
Mailing Address - Phone:203-714-4413
Mailing Address - Fax:203-714-4723
Practice Address - Street 1:787 MAIN ST S UNIT A-5
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-3741
Practice Address - Country:US
Practice Address - Phone:203-714-4413
Practice Address - Fax:203-714-4723
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-27
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001210101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional