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General NPI Number Information
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NPI Number | 1528580289
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Entity Type | Individual
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Provider Name | JENNIFER LYNN COMPETELLO
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Gender | Female
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Dates
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Enumeration Date | 07/13/2017
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 119 N PARK AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-4113
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Country | US
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Telephone | 516-426-4724
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Fax |
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Provider Business Mailing Address
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Address Line | 11 5TH AVE
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City | SOUTH FARMINGDALE
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State | NY
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Zip | 11735-5723
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Country | US
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Telephone | 516-426-4724
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 011743
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License Number State | NY
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