Basic Information
| Provider Information | |||||||||
| NPI: | 1780269779 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHMELKIN | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | MEREL | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | WJCS | ||||||||
| Address2: | 845 NORTH BROADWAY | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106032427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147610600 | ||||||||
| FaxNumber: | 9147615367 | ||||||||
| Practice Location | |||||||||
| Address1: | 845 N BROADWAY | ||||||||
| Address2: | |||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106032403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147610600 | ||||||||
| FaxNumber: | 9147610600 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2021 | ||||||||
| LastUpdateDate: | 03/11/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 078869 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.