Provider Demographics
NPI:1881724003
Name:REISS, JANET J (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:J
Last Name:REISS
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 1:5 RACHEL AVE
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3309
Mailing Address - Country:US
Mailing Address - Phone:631-864-6681
Mailing Address - Fax:631-864-6817
Practice Address - Street 1:11 EVERIT PL
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1703
Practice Address - Country:US
Practice Address - Phone:631-338-8755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR056111-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical