Provider Demographics
NPI:1386761625
Name:STROLL, JANE STANLEY (LCSW, MA)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:STANLEY
Last Name:STROLL
Suffix:
Gender:F
Credentials:LCSW, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 W 22ND ST APT 5G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2710
Mailing Address - Country:US
Mailing Address - Phone:212-929-1327
Mailing Address - Fax:212-866-5890
Practice Address - Street 1:212 W 22ND ST APT 5G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2710
Practice Address - Country:US
Practice Address - Phone:212-929-1327
Practice Address - Fax:212-866-5890
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR054792101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR054792OtherSTATE LICENSE