Provider Demographics
NPI:1992337026
Name:SILIATO, JENNIFER GRACE (LMHC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:GRACE
Last Name:SILIATO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 SMITH PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10302-2045
Mailing Address - Country:US
Mailing Address - Phone:917-515-6888
Mailing Address - Fax:
Practice Address - Street 1:121 SMITH PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10302-2045
Practice Address - Country:US
Practice Address - Phone:917-515-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010094101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY010094OtherSTATE OF NEW YORK EDUCATION DEPARTMENT