Provider Demographics
NPI:1386136786
Name:CHOE, JANDY (LMHC)
Entity type:Individual
Prefix:
First Name:JANDY
Middle Name:
Last Name:CHOE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 JACKMAN DR APT B
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-1220
Mailing Address - Country:US
Mailing Address - Phone:718-813-7026
Mailing Address - Fax:
Practice Address - Street 1:26 STATE ROUTE 17K
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3911
Practice Address - Country:US
Practice Address - Phone:718-813-7026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008353101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty