Provider Demographics
NPI:1811426596
Name:MCNAMARA, JENNIFER ELLIS (LMSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ELLIS
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 THUNDER LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-1336
Mailing Address - Country:US
Mailing Address - Phone:917-376-4024
Mailing Address - Fax:
Practice Address - Street 1:120 EAST AVE STE 2
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5703
Practice Address - Country:US
Practice Address - Phone:203-750-9711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical