Provider Demographics
NPI:1821684374
Name:POWER, JEANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:POWER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11769-1302
Mailing Address - Country:US
Mailing Address - Phone:516-987-2665
Mailing Address - Fax:
Practice Address - Street 1:75 COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:NY
Practice Address - Zip Code:11769-1302
Practice Address - Country:US
Practice Address - Phone:516-987-2665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0743111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical