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General NPI Number Information
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NPI Number | 1225233851
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Entity Type | Individual
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Provider Name | ROBERTA JELLINEKMANSSON PH.D.
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Gender | Female
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 595 W END AVE 7B
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City | NEW YORK
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State | NY
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Zip | 10024-1727
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Country | US
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Telephone | 212-799-9787
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Fax | 212-799-9787
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Provider Business Mailing Address
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Address Line | 595 W END AVE 7B
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City | NEW YORK
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State | NY
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Zip | 10024-1727
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Country | US
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Telephone | 212-799-9787
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Fax | 212-799-9787
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 002850-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | 000744-1
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License Number State | NY
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