Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jazzmine Sue Carrillo

Individual provider Counselor · NPI 1790546059

Jazzmine Sue Carrillo is a Counselor in Groton, Connecticut. Practices as a sole proprietor. Licensed in Connecticut.

Licensed in
CT
In the registry since
2024
Specialties on file
3

Practice location Address checks out

85 Crouch St Apt 15
Groton, CT 06340-3759
Phone: (860) 514-5695
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 1539 (CT)
Counselor Taxonomy 101Y00000X · Licence 1539
Mental Health Counselor Taxonomy 101YM0800X · Licence 1539 (CT)

Record details

NPI number1790546059
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 23, 2024
Last updated in NPPESJanuary 23, 2024
Certification dateJanuary 23, 2024
Mailing address85 Crouch St Apt 15, Groton, CT 06340-3759

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