MEDICARE: JENNIFER K GERMAN LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	01459901	NY

General Provider Information

NPI Number	:	1174370423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER K GERMAN LMHC

Provider Business Mailing Address
First Line	:	466 LAKEVIEW AVE
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07011-4023
Country	:	US
Telephone Number	:	201-667-1747
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 GATEWAY PLZ STE 3B
Second Line	:
City	:	PORT CHESTER
State	:	NY
Zip	:	10573-4681
Country	:	US
Telephone Number	:	914-240-2241
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2024
Last Update Date	:	05/03/2024

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