Provider Demographics
NPI:1396270005
Name:GUMPEL, JAYNE (LCSW)
Entity type:Individual
Prefix:
First Name:JAYNE
Middle Name:
Last Name:GUMPEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 E 42ND ST
Mailing Address - Street 2:SUITE 1535
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10165-0006
Mailing Address - Country:US
Mailing Address - Phone:914-924-1509
Mailing Address - Fax:
Practice Address - Street 1:60 E 42ND ST
Practice Address - Street 2:SUITE 1535
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10165-0006
Practice Address - Country:US
Practice Address - Phone:914-924-1509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02329511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical