Provider Demographics
NPI:1588956536
Name:HENN, JEANNINE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:JEANNINE
Middle Name:
Last Name:HENN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 EAST DR
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-3104
Mailing Address - Country:US
Mailing Address - Phone:718-526-8400
Mailing Address - Fax:718-297-8658
Practice Address - Street 1:9027 SUTPHIN BLVD
Practice Address - Street 2:5TH FLOOR
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-3647
Practice Address - Country:US
Practice Address - Phone:814-880-5707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07828711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical