Provider Demographics
NPI:1528417722
Name:LENSE, JESSICA LAUREN (LMHC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LAUREN
Last Name:LENSE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 E 119TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-3627
Mailing Address - Country:US
Mailing Address - Phone:212-360-4002
Mailing Address - Fax:212-360-4012
Practice Address - Street 1:435 E 119TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-3627
Practice Address - Country:US
Practice Address - Phone:212-360-4002
Practice Address - Fax:212-360-4012
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP01809101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health