Provider Demographics
NPI:1447749221
Name:ROSSOW, JENAI (LCSW)
Entity Type:Individual
Prefix:
First Name:JENAI
Middle Name:
Last Name:ROSSOW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JENAI
Other - Middle Name:
Other - Last Name:DOWNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:3 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:DRYDEN
Mailing Address - State:NY
Mailing Address - Zip Code:13053-9528
Mailing Address - Country:US
Mailing Address - Phone:607-229-2529
Mailing Address - Fax:
Practice Address - Street 1:222 S ALBANY ST
Practice Address - Street 2:STE 1
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5480
Practice Address - Country:US
Practice Address - Phone:607-229-2529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0862251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical