Provider Demographics
NPI:1154528735
Name:JENEFSKY, NADIA E (MPS, ATR-BC, LCAT)
Entity type:Individual
Prefix:MS
First Name:NADIA
Middle Name:E
Last Name:JENEFSKY
Suffix:
Gender:F
Credentials:MPS, ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 BEDFORD AVE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-4067
Mailing Address - Country:US
Mailing Address - Phone:917-293-4642
Mailing Address - Fax:
Practice Address - Street 1:241 BEDFORD AVE
Practice Address - Street 2:SUITE 12
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-4067
Practice Address - Country:US
Practice Address - Phone:917-293-4642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000250101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor