Provider Demographics
NPI:1902006752
Name:BRANCO, JUMOKE O (CRC, LMHC)
Entity Type:Individual
Prefix:MS
First Name:JUMOKE
Middle Name:O
Last Name:BRANCO
Suffix:
Gender:F
Credentials:CRC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1791 BARD LN
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1503
Mailing Address - Country:US
Mailing Address - Phone:516-385-8301
Mailing Address - Fax:
Practice Address - Street 1:1791 BARD LN
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1503
Practice Address - Country:US
Practice Address - Phone:516-385-8301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002181101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health