Provider Demographics
NPI:1760058614
Name:JK PSYCHOLOGICAL CONSULTING LLC
Entity Type:Organization
Organization Name:JK PSYCHOLOGICAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KORNWASSER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:917-434-6631
Mailing Address - Street 1:393 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3024
Mailing Address - Country:US
Mailing Address - Phone:917-434-6631
Mailing Address - Fax:
Practice Address - Street 1:342 GRAND AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4355
Practice Address - Country:US
Practice Address - Phone:917-434-6631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health