Provider Demographics
NPI:1780073049
Name:BADYRKA, JILL L (LMFT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:L
Last Name:BADYRKA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 HENRY AVE
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-4577
Mailing Address - Country:US
Mailing Address - Phone:203-377-7462
Mailing Address - Fax:
Practice Address - Street 1:15 BERKSHIRE RD
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482-1361
Practice Address - Country:US
Practice Address - Phone:203-426-8103
Practice Address - Fax:203-270-4338
Is Sole Proprietor?:No
Enumeration Date:2015-01-09
Last Update Date:2024-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002108106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist