Jelm, Alexis Marie

Jelm, Alexis Marie is an sole proprietor health care provider with primary practice located at 832 Main Street , Willimantic CT 06226-8627. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Jelm, Alexis Marie can be contacted via phone (860) 450-0151.

Contact Information

Primary practice address
832 Main Street Willimantic CT 06226-8627
Phone: (860) 450-0151
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 12836 Connecticut
Behavioral Health & Social Service Providers / Social Worker 104100000X Connecticut
Behavioral Health & Social Service Providers / Clinical 1041C0700X 12836 Connecticut

Profile Details

NPI number 1366183378
LBN Legal business name Jelm, Alexis Marie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 5th, 2022
Last updated Jun 26th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366183378 NPPES
Connecticut MEDICAID 1467500090

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