Provider Demographics
NPI:1689186801
Name:SALAND, JESSE (LCSWR)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:SALAND
Suffix:
Gender:M
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WILL TREMPER DR
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1812
Mailing Address - Country:US
Mailing Address - Phone:845-392-1460
Mailing Address - Fax:
Practice Address - Street 1:8 GARDEN ST
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1357
Practice Address - Country:US
Practice Address - Phone:845-392-1460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-27
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082525-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical