Individual provider · Type 1 NPI

Jessica Waggoner, LCSW

Clinical Social Worker · Manchester, CT

NPI number 1104932938 Active

Practice location

587 Middle Tpke E
Manchester, CT 06040-3731

Call (860) 646-3888 Map

Fax (860) 645-4132

Mailing address

995 Day Hill Rd
Windsor, CT 06095-1722

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X006139 (CT)

Clinical Social Worker: 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 interpers…

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About NPI 1104932938

Jessica Waggoner, LCSW's National Provider Identifier is 1104932938, issued on Aug 22, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Manchester, CT. The record was last updated on Jul 9, 2007.