Provider Demographics
NPI:1528483286
Name:HOGAN, JANE (LCSW, PHD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:
Last Name:HOGAN
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 TARPON COVE DR APT 202
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-3611
Mailing Address - Country:US
Mailing Address - Phone:917-558-0291
Mailing Address - Fax:
Practice Address - Street 1:20 S TYSON AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-2017
Practice Address - Country:US
Practice Address - Phone:917-558-0291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081424-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical