JESSICA PARK (NPI# 1902422488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902422488 |
| Entity Type | Individual |
| Full Name | JESSICA PARK |
| Credential | LMSW |
| Practice Address |
140 N Frontage Rd Mansfield Center CT 06250-1648 |
| Mailing Address |
1007 N Main St Dayville CT 06241-2170 |
| Practice Telephone | 8604562261 |
| Practice Fax Number | 8604501357 |
| Mailing Telephone | 8607742020 |
| Mailing Fax Number | 8607740826 |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2020-06-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
1727 | CT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720481617 | Jessica Jin Hee Park | Pharmacist | 12105 Falcon Crest Way, Porter Ranch, CA 91326-3896 | 2014-10-06 |
| 1942808837 | Jessica Elizabeth Park | Counselor | 3402 Washington Rd Ste 304, Mc Murray, PA 15317-2964 | 2020-10-13 |
| 1184244113 | Jessica Hyunji Park | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se, Mmc 284, Minneapolis, MN 55455 | 2020-04-20 |
| 1790258184 | Jessica Park | Behavior Technician | 3443 Lilly Rd Ne Ste B, Olympia, WA 98506-3091 | 2019-01-08 |
| 1235620428 | Jessica Erin Park | Registered Nurse | 132 Abigail Lane, Port Matilda, PA 16870-7153 | 2018-05-23 |
| 1487197885 | Jessica Park | Optometrist | 7700 W Arrowhead Towne Ctr, Suite 1136, Glendale, AZ 85308-8616 | 2016-12-02 |
| 1033581905 | Jessica Park | Pharmacist | 1833 N Milpitas Blvd, Milpitas, CA 95035-2734 | 2015-10-30 |
| 1285010603 | Jessica Park | Pharmacist | 6432 Losee Rd, North Las Vegas, NV 89086-0100 | 2015-08-07 |
| 1750676292 | Jessica L. Park | Pharmacist | 5717 Ne 138th Ave, Portland, OR 97230-3409 | 2011-06-13 |
| 1851568380 | Jessica G. Park | Physician Assistant | 1600 W Avenue J, Lancaster, CA 93534-2814 | 2008-05-14 |
| Street Address |
140 N FRONTAGE RD |
| City | MANSFIELD CENTER |
| State | CT |
| Zip Code | 06250-1648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225293749 | Sarah Jane C. De Asis | Psychiatry & Neurology | 140 N Frontage Rd, Mansfield Center, CT 06250-1648 | 2008-07-24 |
| 1487254892 | Mackenzie Phelps | Social Worker | 140 N Frontage Rd, Mansfield Center, CT 06250-1648 | 2020-10-27 |
| 1407456932 | Meghan Catherine Mckenna | Social Worker | 140 N Frontage Rd, Mansfield Center, CT 06250-1648 | 2020-10-26 |
| 1548870074 | Tara Bergeron | Social Worker | 140 N Frontage Rd, Mansfield Center, CT 06250-1648 | 2020-08-10 |
| 1174149835 | Ashley Sanzaro | Social Worker | 140 N Frontage Rd, Mansfield Center, CT 06250-1648 | 2020-06-18 |
| 1447875414 | Christopher John Wildenhain | Social Worker | 140 N Frontage Rd, Mansfield Center, CT 06250-1648 | 2020-06-15 |
| 1780204503 | Kathryn Watkins | Social Worker | 140 N Frontage Rd, Mansfield Center, CT 06250-1648 | 2020-04-22 |
| 1952935496 | Debra Abbey | Counselor | 140 N Frontage Rd, Mansfield Center, CT 06250-1648 | 2020-02-24 |
| 1831732247 | Dionna Levy | Counselor | 140 N Frontage Rd, Mansfield Center, CT 06250-1648 | 2019-10-18 |
| 1487205712 | Yuri Troshin | Registered Nurse | 140 N Frontage Rd, Mansfield Center, CT 06250-1648 | 2019-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610765 | Rebecca Hinckley | Physical Therapist | 175 Stafford Road, Mansfield Center, CT 06250 | 2020-08-22 |
| 1649801184 | Kristine Leslie Dimartino | Marriage & Family Therapist | Natchaug Hospital Sachem House, 151 Storrs Road, Mansfield Center, CT 06250 | 2020-02-03 |
| 1942845508 | Philip Fank De Ricco | Massage Therapist | 590 Ash St, Mansfield, CT 06250 | 2019-11-07 |
| 1134772858 | Lauren Curtis | Counselor | 140 North Frontage Road, Mansfield Ctr, CT 06250 | 2019-07-22 |
| 1548747629 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 140 North Frontage Road, Room 171, Mansfield Center, CT 06250 | 2018-07-23 |
| 1366958480 | Mansfield Mental Health & Addiction Medicine | Psychiatry & Neurology | 18-e Ledgebrook Drive, 18-e, Mansfield Ctr, CT 06250 | 2017-12-27 |
| 1124499629 | Laura Jean Lassow | Social Worker | 70 Jacobs Hill Rd, Mansfield Center, CT 06250 | 2015-10-12 |
| 1508105891 | Raymond Karl Bopp | Surgery | 533 Wormwood Hill Road, Mansfield Center, CT 06250 | 2013-02-06 |
| 1992026900 | Carole Laurie Olderman | Social Worker | 189 Storrs Road, 06250, Natchaug Hospital, Mansfield, CT 06250 | 2010-06-14 |
| 1427384775 | Maurice Samuel Lapointe | Marriage & Family Therapist | 365 Storrs Road, Mansfield, CT 06250 | 2009-10-21 |
| Find all providers in zip 06250 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124499629 | Laura Jean Lassow | Social Worker | 70 Jacobs Hill Rd, Mansfield Center, CT 06250 | 2015-10-12 |
| 1366732034 | Kate D'addabbo | Social Worker | 7 Ledgebrook Dr, Mansfield Center, CT 06250-1664 | 2011-04-14 |
| 1689972242 | Julie M Hoagland | Social Worker | 7b Ledgebrook Dr Unit B, Mansfield Center, CT 06250-1664 | 2011-03-07 |
| 1639409055 | Chastity J Pimental | Social Worker | 476 Storrs Rd, Mansfield Center, CT 06250-1254 | 2010-01-07 |
| 1841316395 | Candace F Powers | Social Worker | 2 Ledgebrook Drive, Mansfield Center, CT 06250 | 2007-03-22 |
| 1285766451 | Joann Averill | Social Worker | 6 Storrs Road, Suite # 3, Mansfield Center, CT 06250 | 2007-03-12 |
| 1225172281 | Susan Marie Blayer | Social Worker | 46 Samuel Ln, Mansfield Center, CT 06250-1557 | 2007-02-16 |
| 1992847305 | Lynn Karen Dove | Social Worker | 12c Ledgebrook Dr, Suite #3, Mansfield Center, CT 06250-1664 | 2007-02-13 |
| 1366593865 | Hillary Stern | Social Worker | 134 A Conantville Road, Mansfield Center, CT 06250 | 2007-01-13 |
| 1720178130 | Michael Probert | Social Worker | 7b Ledgebrook Dr, Mansfield Center, CT 06250-1664 | 2006-10-14 |
| Find all providers in MANSFIELD CENTER | ||||
| City | MANSFIELD CENTER |
| Zip Code | 06250 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.