Provider Demographics
NPI:1770035354
Name:JESSICA ALLEN, LCSW, PLLC
Entity Type:Organization
Organization Name:JESSICA ALLEN, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-651-5272
Mailing Address - Street 1:125 E 23RD ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4511
Mailing Address - Country:US
Mailing Address - Phone:646-650-2026
Mailing Address - Fax:646-650-2026
Practice Address - Street 1:125 E 23RD ST
Practice Address - Street 2:SUITE 402
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4511
Practice Address - Country:US
Practice Address - Phone:646-650-2026
Practice Address - Fax:646-650-2026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0846681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty