Provider Demographics
NPI:1306326350
Name:KUPFER, JESSI HANNAH (MHC)
Entity type:Individual
Prefix:
First Name:JESSI
Middle Name:HANNAH
Last Name:KUPFER
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 E 70TH ST APT 12A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5313
Mailing Address - Country:US
Mailing Address - Phone:954-544-8052
Mailing Address - Fax:
Practice Address - Street 1:3109 37TH ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3932
Practice Address - Country:US
Practice Address - Phone:718-721-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty