Provider Demographics
NPI:1619508298
Name:CINICOLO, JENNIFER R (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:R
Last Name:CINICOLO
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 1:280 N CENTRAL AVE STE 40
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1836
Mailing Address - Country:US
Mailing Address - Phone:845-861-5065
Mailing Address - Fax:917-517-1356
Practice Address - Street 1:280 N CENTRAL AVE STE 40
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1836
Practice Address - Country:US
Practice Address - Phone:845-861-5065
Practice Address - Fax:917-517-1356
Is Sole Proprietor?:No
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007133-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health