Provider Demographics
NPI:1235484601
Name:MURAL, JENNIFER (LCSW PLLC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MURAL
Suffix:
Gender:F
Credentials:LCSW PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 ALLENS CREEK RD STE 330
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3246
Mailing Address - Country:US
Mailing Address - Phone:585-512-8626
Mailing Address - Fax:
Practice Address - Street 1:95 ALLENS CREEK RD STE 330
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3246
Practice Address - Country:US
Practice Address - Phone:585-512-8626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-20
Last Update Date:2024-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077866-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical