Provider Demographics
NPI:1699199158
Name:VEROLINE, JESSICA G
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:G
Last Name:VEROLINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 LONG PINE ROAD
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:PA
Mailing Address - Zip Code:18425
Mailing Address - Country:US
Mailing Address - Phone:406-941-2379
Mailing Address - Fax:
Practice Address - Street 1:930 RAZ AVENUE
Practice Address - Street 2:ARC OF ORANGE COUNTY NEW WINDSOR PLE
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553
Practice Address - Country:US
Practice Address - Phone:845-564-1855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY089829104100000X
NJ44SL06263300104100000X
ND49421041C0700X
RIISW027271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker