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General NPI Number Information
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NPI Number | 1538043534
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Entity Type | Individual
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Provider Name | JANNIE ALICIA MORALES CASAC-T
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Gender | Female
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1614 WEIRFIELD ST
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City | RIDGEWOOD
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State | NY
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Zip | 11385-5350
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Country | US
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Telephone | 718-456-7820
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Fax |
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Provider Business Mailing Address
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Address Line | 16419 104TH RD
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City | JAMAICA
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State | NY
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Zip | 11433-2104
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Country | US
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Telephone | 718-350-0548
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CASAC-T-39820
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License Number State | NY
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