Healthcare Provider Details

I. General information

NPI: 1750218384
Provider Name (Legal Business Name): JENNA BETH SPECTOR LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

558 PALM LN
WEST HEMPSTEAD NY
11552-3024
US

IV. Provider business mailing address

558 PALM LN
WEST HEMPSTEAD NY
11552-3024
US

V. Phone/Fax

Practice location:
  • Phone: 718-551-4987
  • Fax:
Mailing address:
  • Phone: 718-551-4987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number121256-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: