Provider Demographics
NPI:1205366317
Name:HERKEL, JENNIFER PAUL (SCHOOL PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PAUL
Last Name:HERKEL
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:PAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SCHOOL PSYCHOLOGIST
Mailing Address - Street 1:10551 STATE ROUTE 365
Mailing Address - Street 2:
Mailing Address - City:BARNEVELD
Mailing Address - State:NY
Mailing Address - Zip Code:13304-2435
Mailing Address - Country:US
Mailing Address - Phone:315-534-9541
Mailing Address - Fax:
Practice Address - Street 1:130 LOMOND CT
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5957
Practice Address - Country:US
Practice Address - Phone:315-534-9541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool