Provider Demographics
NPI:1003700964
Name:YELLEN, JENNA
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:YELLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 NEW HEMPSTEAD RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-2427
Mailing Address - Country:US
Mailing Address - Phone:845-570-3308
Mailing Address - Fax:
Practice Address - Street 1:413 STRAWTOWN RD
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-1222
Practice Address - Country:US
Practice Address - Phone:845-624-3473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool