Healthcare Provider Details

I. General information

NPI: 1235264334
Provider Name (Legal Business Name): JODI LYNNE TAFARELLA-KUNZ PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 FLORAL AVE
PLAINVIEW NY
11803-5223
US

IV. Provider business mailing address

214 FLORAL AVE
PLAINVIEW NY
11803-5223
US

V. Phone/Fax

Practice location:
  • Phone: 516-622-6275
  • Fax:
Mailing address:
  • Phone: 516-622-6275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number014474.1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number014474.1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: