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NPI 1174109342

NPI 1174109342 : JENNIFER COLBY LCSW PLLC : RYE BROOK, NY

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General NPI Number Information
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    NPI Number           |    1174109342
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    Entity Type          |    Organization 
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    Legal Business Name  |    JENNIFER COLBY LCSW PLLC 
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Dates
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    Enumeration Date     |    03/19/2021
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    Last Update Date     |    03/19/2021
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Provider Practice Location Address
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    Address Line         |    41 TAMARACK RD 
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    City                 |    RYE BROOK
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    State                |    NY
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    Zip                  |    10573-2434
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    Country              |    US
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    Telephone            |    203-979-2057
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    41 TAMARACK RD 
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    City                 |    RYE BROOK
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    State                |    NY
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    Zip                  |    10573-2434
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    Country              |    US
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    Telephone            |    203-979-2057
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     JENNIFER  COLBY 
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    Credential           |    LCSW
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    Telephone            |    203-979-2057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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