Provider Demographics
NPI:1356658363
Name:NARAYAN, JASMINE (PSYD)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:NARAYAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 PROSPECT ST STE 101
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3320
Mailing Address - Country:US
Mailing Address - Phone:631-268-0009
Mailing Address - Fax:631-268-0009
Practice Address - Street 1:75 PROSPECT ST STE 101
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3320
Practice Address - Country:US
Practice Address - Phone:631-268-0009
Practice Address - Fax:631-268-0009
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018942103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent