Provider Demographics
NPI:1609539915
Name:FLEISCHER, JAY (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JAY
Middle Name:
Last Name:FLEISCHER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 ROBERT PITT DR
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-3333
Mailing Address - Country:US
Mailing Address - Phone:845-770-1968
Mailing Address - Fax:845-503-2214
Practice Address - Street 1:42 MELNICK DR
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3328
Practice Address - Country:US
Practice Address - Phone:845-770-1949
Practice Address - Fax:845-503-2214
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11393201104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty