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General NPI Number Information
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NPI Number | 1306950977
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Entity Type | Organization
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Legal Business Name | JERICHO CONSULTING INC.
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 09/22/2009
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Provider Practice Location Address
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Address Line | 27 LIBERTY SQUARE MALL
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City | STONY POINT
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State | NY
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Zip | 10980-2400
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Country | US
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Telephone | 845-300-7972
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Fax | 845-270-7938
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Provider Business Mailing Address
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Address Line | 48 CLOVE AVE
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City | HAVERSTRAW
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State | NY
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Zip | 10927-1804
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Country | US
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Telephone | 845-300-7972
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Fax | 845-270-7933
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MRS. RAFAELINA MERCEDES ACOSTA
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Credential | L.C.S.W.
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Telephone | 845-300-7972
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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 | 071021
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License Number State | NY
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