Provider Demographics
NPI:1487728168
Name:MEZEY, JENNIFER (LCSW,)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MEZEY
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 1:27 HIDDEN LN
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6524
Mailing Address - Country:US
Mailing Address - Phone:516-717-9050
Mailing Address - Fax:516-710-7868
Practice Address - Street 1:27 HIDDEN LN
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-6524
Practice Address - Country:US
Practice Address - Phone:516-717-9050
Practice Address - Fax:516-710-7868
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NY081090-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)