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NPI Code Detail

MEDICARE: JENISE PENA LMSW, CASAC-A

MEDICARE: JENISE PENA LMSW, CASAC-A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
21041C0700XClinical Social Worker129980NY

General Provider Information

NPI Number : 1235815713
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENISE PENA LMSW, CASAC-A
Provider Business Mailing Address
First Line : 2000 MAPLE HILL ST
Second Line :
City : YORKTOWN HEIGHTS
State : NY
Zip : 10598-4176
Country : US
Telephone Number : 914-962-5101
Fax Number :
Provider Business Practice Location Address
First Line : 2000 MAPLE HILL ST
Second Line :
City : YORKTOWN HEIGHTS
State : NY
Zip : 10598-4176
Country : US
Telephone Number : 914-962-5101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2023
Last Update Date : 12/10/2025

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Directions to “ JENISE PENA LMSW, CASAC-A” Practice Location

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