Provider Demographics
NPI:1841497443
Name:SILACCI, JENNIFER (LCSW-R)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SILACCI
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 RIVERSIDE DR
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3726
Mailing Address - Country:US
Mailing Address - Phone:212-627-0770
Mailing Address - Fax:
Practice Address - Street 1:125 RIVERSIDE DR
Practice Address - Street 2:SUITE 1E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3726
Practice Address - Country:US
Practice Address - Phone:212-627-0770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0768601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical