Provider Demographics
NPI:1982012274
Name:HORSLEY, JAMAL
Entity type:Individual
Prefix:
First Name:JAMAL
Middle Name:
Last Name:HORSLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SADORE LN
Mailing Address - Street 2:1O
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-4752
Mailing Address - Country:US
Mailing Address - Phone:914-618-2339
Mailing Address - Fax:
Practice Address - Street 1:4 SADORE LN
Practice Address - Street 2:1O
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-4752
Practice Address - Country:US
Practice Address - Phone:914-618-2339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP94117101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health