Provider Demographics
NPI:1811256613
Name:SOMBERG, JAYMEE LAUREN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JAYMEE
Middle Name:LAUREN
Last Name:SOMBERG
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 1:100 PHILLIPS HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-4134
Mailing Address - Country:US
Mailing Address - Phone:646-463-2013
Mailing Address - Fax:607-203-5559
Practice Address - Street 1:100 PHILLIPS HILL RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-4134
Practice Address - Country:US
Practice Address - Phone:646-463-2013
Practice Address - Fax:607-203-5559
Is Sole Proprietor?:No
Enumeration Date:2012-05-14
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0788021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY078802OtherNYS LICENSE