Provider Demographics
NPI:1891968731
Name:LARABEE, JACQUELINE CHENOT (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:CHENOT
Last Name:LARABEE
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 1:301 S ALLEN ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-2070
Mailing Address - Country:US
Mailing Address - Phone:518-225-2315
Mailing Address - Fax:518-446-9191
Practice Address - Street 1:301 S ALLEN ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-2070
Practice Address - Country:US
Practice Address - Phone:518-225-2315
Practice Address - Fax:518-446-9191
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-11
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0762331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY076233OtherNYS OFFICE OF THE PROFESSIONS