Provider Demographics
NPI:1073210241
Name:BABEKOV, JENNIFER (LMHC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BABEKOV
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-4757
Mailing Address - Country:US
Mailing Address - Phone:917-733-7864
Mailing Address - Fax:
Practice Address - Street 1:111 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-4757
Practice Address - Country:US
Practice Address - Phone:917-733-7864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012953101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health