Provider Demographics
NPI:1912121062
Name:KASKEL, JESSICA L (LCSW)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:L
Last Name:KASKEL
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 1:175 ADAMS ST
Mailing Address - Street 2:4D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1850
Mailing Address - Country:US
Mailing Address - Phone:646-541-1390
Mailing Address - Fax:
Practice Address - Street 1:3974 AMBOY RD
Practice Address - Street 2:SUITE 207
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308-2448
Practice Address - Country:US
Practice Address - Phone:646-541-1390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069789-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical