Provider Demographics
NPI:1265981153
Name:PETTENATO, JOCELYN ROSE (LCSW)
Entity type:Individual
Prefix:MISS
First Name:JOCELYN
Middle Name:ROSE
Last Name:PETTENATO
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 1:1280 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2105
Mailing Address - Country:US
Mailing Address - Phone:203-718-3826
Mailing Address - Fax:203-902-2370
Practice Address - Street 1:1280 LEXINGTON AVE # F2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2105
Practice Address - Country:US
Practice Address - Phone:203-718-3826
Practice Address - Fax:203-902-2370
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-03
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0900241041C0700X
CT140231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical