MEDICARE: JENNIFER MCARDLE

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	002661-01	NY

General Provider Information

NPI Number	:	1205694130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MCARDLE

Provider Business Mailing Address
First Line	:	216 LAKEVIEW PL
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10471-3014
Country	:	US
Telephone Number	:	718-612-6783
Fax Number	:

Provider Business Practice Location Address
First Line	:	216 LAKEVIEW PL
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10471-3014
Country	:	US
Telephone Number	:	718-612-6783
Fax Number	:

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

Provider Enumeration Date	:	03/06/2024
Last Update Date	:	03/06/2024

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Directions to “ JENNIFER MCARDLE ” Practice Location

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