Provider Demographics
NPI:1780080168
Name:KNOLL, JENNA (LMHC)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:KNOLL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:TYRANGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHC-LP
Mailing Address - Street 1:LISA DRUCKREIER: HUMAN RESOURCES COORDINATOR
Mailing Address - Street 2:6339 MILL ST
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572
Mailing Address - Country:US
Mailing Address - Phone:845-871-1099
Mailing Address - Fax:845-876-4578
Practice Address - Street 1:750 TILDEN STREET
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-231-3400
Practice Address - Fax:718-655-3503
Is Sole Proprietor?:No
Enumeration Date:2014-11-12
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor