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General NPI Number Information
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NPI Number | 1336893072
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Entity Type | Individual
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Provider Name | MONIQUE KERNISAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/11/2022
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Last Update Date | 10/19/2024
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Provider Practice Location Address
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Address Line | 239 N BROADWAY
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City | SLEEPY HOLLOW
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State | NY
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Zip | 10591-2674
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Country | US
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Telephone | 914-517-0502
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Fax |
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Provider Business Mailing Address
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Address Line | 203 LEGEND DR APT 2301
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City | SLEEPY HOLLOW
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State | NY
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Zip | 10591-2964
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Country | US
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Telephone | 845-826-5739
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Fax |
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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 | 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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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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