Healthcare Provider Details

I. General information

NPI: 1376893982
Provider Name (Legal Business Name): JESSICA TRIFILETTI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2012
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 3RD ST
YORKVILLE NY
13495-1522
US

IV. Provider business mailing address

42 3RD ST
YORKVILLE NY
13495-1522
US

V. Phone/Fax

Practice location:
  • Phone: 716-299-9871
  • Fax:
Mailing address:
  • Phone: 716-299-9871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number088048
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: