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NPI Code Detail

MEDICARE: JAMIE VOLLMOELLER LCSW

MEDICARE: JAMIE VOLLMOELLER 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 Worker087409NY

General Provider Information

NPI Number : 1720432032
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE VOLLMOELLER LCSW
Provider Business Mailing Address
First Line : 4109 SUNRISE HWY
Second Line :
City : BOHEMIA
State : NY
Zip : 11716-4600
Country : US
Telephone Number : 631-707-2794
Fax Number :
Provider Business Practice Location Address
First Line : 4109 SUNRISE HWY
Second Line :
City : BOHEMIA
State : NY
Zip : 11716-4600
Country : US
Telephone Number : 631-503-1539
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2016
Last Update Date : 01/20/2025

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