Provider Demographics
NPI:1942922844
Name:PAPITTO, JESSICA KATE (LCSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:KATE
Last Name:PAPITTO
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 1:1719 STANHOPE ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-1440
Mailing Address - Country:US
Mailing Address - Phone:954-261-3894
Mailing Address - Fax:
Practice Address - Street 1:1719 STANHOPE ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-1440
Practice Address - Country:US
Practice Address - Phone:954-261-3894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-16
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0878321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical