Provider Demographics
NPI:1700028685
Name:SEHAM, JENNY CLARISSA (PHD)
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:CLARISSA
Last Name:SEHAM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 W 105TH ST
Mailing Address - Street 2:APT. 6C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3916
Mailing Address - Country:US
Mailing Address - Phone:917-533-2832
Mailing Address - Fax:
Practice Address - Street 1:230 W 105TH ST
Practice Address - Street 2:APT. 6C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-3916
Practice Address - Country:US
Practice Address - Phone:212-496-0176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013807103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist