Healthcare Provider Details

I. General information

NPI: 1144903899
Provider Name (Legal Business Name): JACLYN GIOFFRE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10236 64TH AVE APT 6J
FOREST HILLS NY
11375-1508
US

IV. Provider business mailing address

6 SURREY DR
RIVERSIDE CT
06878-1516
US

V. Phone/Fax

Practice location:
  • Phone: 929-445-2107
  • Fax:
Mailing address:
  • Phone: 914-523-7057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number016427
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: