Provider Demographics
NPI:1306023478
Name:WOLFARTH, JESSICA (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:
Last Name:WOLFARTH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3770 VERLEYE ST
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2517
Mailing Address - Country:US
Mailing Address - Phone:516-253-0225
Mailing Address - Fax:
Practice Address - Street 1:3770 VERLEYE ST
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-2517
Practice Address - Country:US
Practice Address - Phone:516-253-0225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical