Provider Demographics
NPI:1750360756
Name:PALINKAS, JUDITH ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANN
Last Name:PALINKAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:WEST HARTLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06091-4307
Mailing Address - Country:US
Mailing Address - Phone:860-238-7520
Mailing Address - Fax:860-738-9956
Practice Address - Street 1:310 CENTER ST
Practice Address - Street 2:
Practice Address - City:WEST HARTLAND
Practice Address - State:CT
Practice Address - Zip Code:06091-4307
Practice Address - Country:US
Practice Address - Phone:860-238-7520
Practice Address - Fax:860-738-9956
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT800003543CTOtherMEDICARE IDENTIFICATION NUMBER
522914OtherMAGELLAN
2032678OtherCIGNA
7077305OtherAETNA
350892OtherVALUE OPTION VENDOR
CT004198942Medicaid
140004529CT02OtherBC
303644OtherCTCARE
CT004198942Medicaid