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NPI 1992586168

NPI 1992586168 : JESSICA CROCE PSYCHOTHERAPY : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1992586168
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    Entity Type          |    Organization 
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    Legal Business Name  |    JESSICA CROCE PSYCHOTHERAPY 
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Dates
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    Enumeration Date     |    10/12/2023
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    Last Update Date     |    10/12/2023
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Provider Practice Location Address
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    Address Line         |    53 E 34TH ST STE 206 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10016-4332
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    Country              |    US
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    Telephone            |    347-403-2286
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    209 CLINTON AVE APT 4E 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11205-3536
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    Country              |    US
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    Telephone            |    347-403-2286
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     JESSICA  CROCE 
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    Credential           |    LCSW
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    Telephone            |    347-403-2286
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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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