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General NPI Number Information
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NPI Number | 1730842410
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Entity Type | Organization
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Legal Business Name | JENNA BOGETTI MENTAL HEALTH COUNSELING
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Dates
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Enumeration Date | 10/19/2021
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Last Update Date | 10/19/2021
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Provider Practice Location Address
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Address Line | 552 W LAKE DR STE 4
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City | MONTAUK
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State | NY
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Zip | 11954-5494
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Country | US
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Telephone | 914-494-4430
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Fax |
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Provider Business Mailing Address
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Address Line | 669 MAIN ST UNIT 143
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-7101
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Country | US
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Telephone | 914-494-4430
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNA BOGETTI
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Credential | PC
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Telephone | 914-494-4430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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