Provider Demographics
NPI:1194295006
Name:HITCHENS PARKER, JANINE LAURA (LCSW)
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:LAURA
Last Name:HITCHENS PARKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JANINE
Other - Middle Name:LAURA
Other - Last Name:HITCHENS PRAKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:501 LOMBARD ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06513-2910
Mailing Address - Country:US
Mailing Address - Phone:203-787-2207
Mailing Address - Fax:203-773-3626
Practice Address - Street 1:501 LOMBARD ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513-2910
Practice Address - Country:US
Practice Address - Phone:203-787-2207
Practice Address - Fax:203-773-3626
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT87071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical