Healthcare Provider Details

I. General information

NPI: 1821179177
Provider Name (Legal Business Name): JENNIFER PARSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 REMSEN ST 10TH FLOOR
BROOKLYN NY
11201-4300
US

IV. Provider business mailing address

175 REMSEN ST 10TH FLOOR
BROOKLYN NY
11201-4300
US

V. Phone/Fax

Practice location:
  • Phone: 718-852-5552
  • Fax: 718-852-5666
Mailing address:
  • Phone: 718-852-5552
  • Fax: 718-852-5666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number070383-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: