Healthcare Provider Details

I. General information

NPI: 1629996038
Provider Name (Legal Business Name): JENNA CHRISTINA PICCINONE NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 JOHNSON AVE
SAYVILLE NY
11782-1199
US

IV. Provider business mailing address

350 LINCOLN RD
PATCHOGUE NY
11772-1769
US

V. Phone/Fax

Practice location:
  • Phone: 631-589-8060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: