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NPI Code Detail

MEDICARE: JENNIFER LYNN RUDD LCSW

MEDICARE: JENNIFER LYNN RUDD LCSW
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
11041C0700XClinical Social Worker102194NY

General Provider Information

NPI Number : 1326771221
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LYNN RUDD LCSW
Provider Business Mailing Address
First Line : 21 BLOOMINGDALE RD
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10605-1504
Country : US
Telephone Number : 914-815-2269
Fax Number :
Provider Business Practice Location Address
First Line : 21 BLOOMINGDALE RD
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10605-1504
Country : US
Telephone Number : 914-815-2269
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2022
Last Update Date : 02/13/2026

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Directions to “ JENNIFER LYNN RUDD LCSW” Practice Location

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