Provider Demographics
NPI:1891441085
Name:O'CONNOR-LOBATO, JENNIFER CORAL (LMHC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CORAL
Last Name:O'CONNOR-LOBATO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 LAWNRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3111
Mailing Address - Country:US
Mailing Address - Phone:518-396-7789
Mailing Address - Fax:
Practice Address - Street 1:13 LAWNRIDGE AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3111
Practice Address - Country:US
Practice Address - Phone:518-396-7789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006770101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health