Healthcare Provider Details

I. General information

NPI: 1437947645
Provider Name (Legal Business Name): JENNIFER SCHULTZ LMSW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 S BROADWAY STE 208
WHITE PLAINS NY
10601-4431
US

IV. Provider business mailing address

34 S BROADWAY STE 407
WHITE PLAINS NY
10601-4430
US

V. Phone/Fax

Practice location:
  • Phone: 917-426-1947
  • Fax:
Mailing address:
  • Phone: 917-426-1947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JENNIFER LELAND DIVALENTINO
Title or Position: FOUNDER AND CLINICAL DIRECTOR
Credential: LCSW
Phone: 917-426-1947