Provider Demographics
NPI:1851525224
Name:BAHME, JENNIFER L (MS, LMSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:BAHME
Suffix:
Gender:F
Credentials:MS, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 W 90TH ST
Mailing Address - Street 2:APARTMENT A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1114
Mailing Address - Country:US
Mailing Address - Phone:212-580-4841
Mailing Address - Fax:
Practice Address - Street 1:269 W 90TH ST
Practice Address - Street 2:APARTMENT A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1114
Practice Address - Country:US
Practice Address - Phone:212-580-4841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056446-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical