Provider Demographics
NPI:1871268284
Name:BROWN, JENNIFER YVETTE (LMSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:YVETTE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CHADWICK GDNS APT A29
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3430
Mailing Address - Country:US
Mailing Address - Phone:914-262-1611
Mailing Address - Fax:
Practice Address - Street 1:2 CHADWICK GDNS APT A29
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3430
Practice Address - Country:US
Practice Address - Phone:914-262-1611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10953101101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional