Provider Demographics
NPI:1528750189
Name:JIMENEZ, MARITZA (LMSW)
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MARITZA
Other - Middle Name:
Other - Last Name:JIMENEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:329 CORDIAL RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2642
Mailing Address - Country:US
Mailing Address - Phone:914-525-6140
Mailing Address - Fax:
Practice Address - Street 1:329 CORDIAL RD
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2642
Practice Address - Country:US
Practice Address - Phone:914-525-6140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1149261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical