Basic Information
Provider Information
NPI: 1619244233
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINARSKI
FirstName: JESSICA
MiddleName: SANDRA
NamePrefix:  
NameSuffix:  
Credential: LPCMH
OtherOrganizationName:  
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OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 240 N JAMES ST
Address2: SUITE 200
City: NEWPORT
State: DE
PostalCode: 198043169
CountryCode: US
TelephoneNumber: 3026330301
FaxNumber: 3026330331
Practice Location
Address1: 240 N JAMES ST
Address2: SUITE 200
City: NEWPORT
State: DE
PostalCode: 198043169
CountryCode: US
TelephoneNumber: 3026330301
FaxNumber: 3026330331
Other Information
ProviderEnumerationDate: 11/28/2011
LastUpdateDate: 11/28/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X004602-1NYN Behavioral Health & Social Service ProvidersCounselorMental Health
101YP2500XPC-0000572DEY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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