Provider Demographics
NPI:1033532940
Name:COREA, JESSICA (LMHC, CASAC-T)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:COREA
Suffix:
Gender:F
Credentials:LMHC, CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 STEWART AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4785
Mailing Address - Country:US
Mailing Address - Phone:516-280-7285
Mailing Address - Fax:516-280-7286
Practice Address - Street 1:585 STEWART AVE STE 700
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4785
Practice Address - Country:US
Practice Address - Phone:516-280-7285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-28
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health