Provider Demographics
NPI:1275027997
Name:BYRNES, JEANNE (LMHC)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:BYRNES
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 1:3721 WOODBINE AVE
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3044
Mailing Address - Country:US
Mailing Address - Phone:516-781-4175
Mailing Address - Fax:
Practice Address - Street 1:21 GREENE AVE STE 204
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2943
Practice Address - Country:US
Practice Address - Phone:516-743-8571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-16
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0006501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health