Provider Demographics
NPI:1306838107
Name:ASMA, JEANNE FRANCIS (LCSW-R)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:FRANCIS
Last Name:ASMA
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 MACGHEE RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-4358
Mailing Address - Country:US
Mailing Address - Phone:845-462-1182
Mailing Address - Fax:845-462-4669
Practice Address - Street 1:98 MACGHEE RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-4358
Practice Address - Country:US
Practice Address - Phone:845-462-1182
Practice Address - Fax:845-462-4669
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055087-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY055087-1OtherSW LICENSE
NYNOJ781Medicare PIN