Provider Demographics
NPI:1285040055
Name:MONESTIME, JEFFREY (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:MONESTIME
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WHEELER CT
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-4111
Mailing Address - Country:US
Mailing Address - Phone:347-301-4171
Mailing Address - Fax:
Practice Address - Street 1:8 WHEELER CT
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-4111
Practice Address - Country:US
Practice Address - Phone:347-301-4171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008272101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1285040055Medicaid