Provider Demographics
NPI:1831698745
Name:DANCHICK, JOCELYNE S (MA)
Entity type:Individual
Prefix:
First Name:JOCELYNE
Middle Name:S
Last Name:DANCHICK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 SAINT MARKS AVE APT 2C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4996
Mailing Address - Country:US
Mailing Address - Phone:505-428-8668
Mailing Address - Fax:
Practice Address - Street 1:6423 ROUTE 55
Practice Address - Street 2:
Practice Address - City:WINGDALE
Practice Address - State:NY
Practice Address - Zip Code:12594-1501
Practice Address - Country:US
Practice Address - Phone:845-350-3010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0181681101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty