Provider Demographics
NPI:1518141332
Name:BERLIN, JESSICA S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:S
Last Name:BERLIN
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 1:2215 43RD AVE
Mailing Address - Street 2:STEINWAY CHILD AND FAMILY SERVICES
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2215 43RD AVE
Practice Address - Street 2:STEINWAY CHILD AND FAMILY SERVICES
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5018
Practice Address - Country:US
Practice Address - Phone:718-652-4865
Practice Address - Fax:718-784-2920
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0727711041C0700X
NY077150-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical