Provider Demographics
NPI:1063984516
Name:ZEITLIN, JENNIFER ROSE (LMSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ROSE
Last Name:ZEITLIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-2302
Mailing Address - Country:US
Mailing Address - Phone:914-261-7417
Mailing Address - Fax:
Practice Address - Street 1:207 E 94TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3705
Practice Address - Country:US
Practice Address - Phone:212-939-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1049121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical