Provider Demographics
NPI:1720107055
Name:TODORSKI, JANE REYNOLDS (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:REYNOLDS
Last Name:TODORSKI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:JANE
Other - Middle Name:ELLIS
Other - Last Name:REYNOLDS TODORSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:204 OLD LITCHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06793-1116
Mailing Address - Country:US
Mailing Address - Phone:860-868-7585
Mailing Address - Fax:860-868-6071
Practice Address - Street 1:42 MAIN STREET
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776
Practice Address - Country:US
Practice Address - Phone:203-788-4275
Practice Address - Fax:860-868-6071
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000812106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT410000812CT02OtherANTHEM INSURANCE