Healthcare Provider Details

I. General information

NPI: 1215460944
Provider Name (Legal Business Name): JENNIFER BATELIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 OLD QUAKER HILL RD
PAWLING NY
12564-3453
US

IV. Provider business mailing address

744 OLD QUAKER HILL RD
PAWLING NY
12564-3453
US

V. Phone/Fax

Practice location:
  • Phone: 845-857-8236
  • Fax:
Mailing address:
  • Phone: 845-857-8236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number014378
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: