Provider Demographics
NPI:1780735100
Name:MONE, JEAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:MONE
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 1:18 HUNTINGTON RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-6803
Mailing Address - Country:US
Mailing Address - Phone:917-312-3250
Mailing Address - Fax:917-451-5304
Practice Address - Street 1:18 HUNTINGTON RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-6803
Practice Address - Country:US
Practice Address - Phone:917-312-3250
Practice Address - Fax:917-451-5304
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR050960-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N65911Medicare UPIN