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Contact Information

JESSICA M GAGNON, LCSW
428 LONG HILL RD STE 201
GROTON, CT06340
 Phone: 860-705-2840
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for JESSICA M GAGNON · (Female)

NPI Number 1194038174
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 07/20/2010
Last updated 08/19/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • CT Medicaid 004040564
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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