Provider Demographics
NPI:1356494280
Name:ESSA, JANICE LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:LYNN
Last Name:ESSA
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 1:1061 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-4111
Mailing Address - Country:US
Mailing Address - Phone:718-677-5525
Mailing Address - Fax:718-232-9325
Practice Address - Street 1:1061 E 12TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-4111
Practice Address - Country:US
Practice Address - Phone:718-677-5525
Practice Address - Fax:718-232-9325
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03588311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical