Provider Demographics
NPI:1205982204
Name:SEDLER, JENNIFER SHIRLYNE (LMSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:SHIRLYNE
Last Name:SEDLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:SHIRLYNE
Other - Last Name:MAKHLOUF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:100 N VILLAGE AVE
Mailing Address - Street 2:SUITE 34
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3767
Mailing Address - Country:US
Mailing Address - Phone:516-587-3383
Mailing Address - Fax:
Practice Address - Street 1:100 N VILLAGE AVE
Practice Address - Street 2:SUITE 34
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3767
Practice Address - Country:US
Practice Address - Phone:516-587-3383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2008-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073997-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker