=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639083108
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JESSICA ADRIANA SALTOS LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2026
-----------------------------------------------------
Last Update Date | 09/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 697 KING ST
-----------------------------------------------------
City | PORT CHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10573-2337
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-565-3414
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 560 WHITE PLAINS RD STE 200
-----------------------------------------------------
City | TARRYTOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10591-5113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-565-3414
-----------------------------------------------------
Fax | 914-941-8626
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 12579
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 133591
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------