Provider Demographics
NPI:1609380435
Name:JENTEX TRAINING & CONSULTING
Entity Type:Organization
Organization Name:JENTEX TRAINING & CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:631-231-4704
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-0430
Mailing Address - Country:US
Mailing Address - Phone:631-231-4704
Mailing Address - Fax:631-231-4704
Practice Address - Street 1:159 TWIN LAWNS AVE
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-6019
Practice Address - Country:US
Practice Address - Phone:631-231-4704
Practice Address - Fax:631-231-4704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0763841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty