Provider Demographics
NPI:1467424010
Name:SINIBALDI, JEANNETTE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JEANNETTE
Middle Name:
Last Name:SINIBALDI
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 1:6620 WETHEROLE ST APT 4E
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4619
Mailing Address - Country:US
Mailing Address - Phone:718-544-6789
Mailing Address - Fax:
Practice Address - Street 1:7158 AUSTIN ST STE 101
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4788
Practice Address - Country:US
Practice Address - Phone:718-544-6789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR029083-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN11481Medicare ID - Type Unspecified