Provider Demographics
NPI:1467725366
Name:GEYER, JENNA ROSE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JENNA
Middle Name:ROSE
Last Name:GEYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:JENNA
Other - Middle Name:ROSE
Other - Last Name:GEYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:400 DOANSBURG RD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-5902
Mailing Address - Country:US
Mailing Address - Phone:845-279-2995
Mailing Address - Fax:845-279-4972
Practice Address - Street 1:400 DOANSBURG RD
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-5902
Practice Address - Country:US
Practice Address - Phone:845-279-2995
Practice Address - Fax:845-279-4972
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-23
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0846271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical