Provider Demographics
NPI:1598195026
Name:MORAGAS, JENNIFER (MS, CASAC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MORAGAS
Suffix:
Gender:F
Credentials:MS, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 TOLEMAN RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10992-1106
Mailing Address - Country:US
Mailing Address - Phone:845-496-5258
Mailing Address - Fax:
Practice Address - Street 1:671 STATE ROUTE 17M
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-3318
Practice Address - Country:US
Practice Address - Phone:845-837-1635
Practice Address - Fax:845-837-1634
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27659101YA0400X
NYP84563101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health