MEDICARE: JACQUELYN KEMPTON

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	P141308	NY

General Provider Information

NPI Number	:	1336096544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELYN KEMPTON

Provider Business Mailing Address
First Line	:	735 RAMONA AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10309-2153
Country	:	US
Telephone Number	:	917-636-2013
Fax Number	:

Provider Business Practice Location Address
First Line	:	153 NEW DORP LN
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-3050
Country	:	US
Telephone Number	:	347-696-1916
Fax Number	:

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

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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Directions to “ JACQUELYN KEMPTON ” Practice Location

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