Provider Demographics
NPI:1962948026
Name:JENNY YOVINE LCSW PLLC
Entity type:Organization
Organization Name:JENNY YOVINE LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:L
Authorized Official - Last Name:YOVINE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:646-872-8485
Mailing Address - Street 1:79 TACONIC RD
Mailing Address - Street 2:
Mailing Address - City:MILLWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:10546-1126
Mailing Address - Country:US
Mailing Address - Phone:646-872-8485
Mailing Address - Fax:
Practice Address - Street 1:79 TACONIC RD
Practice Address - Street 2:
Practice Address - City:MILLWOOD
Practice Address - State:NY
Practice Address - Zip Code:10546-1126
Practice Address - Country:US
Practice Address - Phone:646-872-8485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-13
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR075786-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty