Provider Demographics
NPI:1427156504
Name:NOL, JOSEPHINE (PHD,)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:NOL
Suffix:
Gender:F
Credentials:PHD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WOMEN'S CENTER FOR PSYCHOTHERAPY
Mailing Address - Street 2:784 FARMINGTON AVENUE
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-0000
Mailing Address - Country:US
Mailing Address - Phone:860-523-4450
Mailing Address - Fax:860-523-9537
Practice Address - Street 1:WOMEN'S CENTER FOR PSYCHOTHERAPY
Practice Address - Street 2:784 FARMINGTON AVENUE
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-0000
Practice Address - Country:US
Practice Address - Phone:860-523-4450
Practice Address - Fax:860-523-9537
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0022641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT800001345Medicare ID - Type Unspecified