Provider Demographics
NPI:1174870836
Name:HASKINS, JINESE DENEA (LCSW)
Entity type:Individual
Prefix:MS
First Name:JINESE
Middle Name:DENEA
Last Name:HASKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1647 LINCOLN PL FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-5102
Mailing Address - Country:US
Mailing Address - Phone:347-481-8051
Mailing Address - Fax:
Practice Address - Street 1:1647 LINCOLN PL FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-5102
Practice Address - Country:US
Practice Address - Phone:347-481-8051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-12
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085918-1104100000X
NY0861151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker