MEDICARE: JESICA ELIZABETH MCLAUGHLIN

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
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1942043153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESICA ELIZABETH MCLAUGHLIN

Provider Business Mailing Address
First Line	:	33 W 60TH ST FL 6
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-7905
Country	:	US
Telephone Number	:	718-228-9820
Fax Number	:

Provider Business Practice Location Address
First Line	:	460 E 21ST ST APT 1F
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-6090
Country	:	US
Telephone Number	:	347-777-0552
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2024
Last Update Date	:	06/15/2024

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