Provider Demographics
NPI:1942930011
Name:JENNINGS, JULENE (LMSW)
Entity type:Individual
Prefix:
First Name:JULENE
Middle Name:
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2161
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06813-2161
Mailing Address - Country:US
Mailing Address - Phone:203-731-7671
Mailing Address - Fax:
Practice Address - Street 1:100 N BROADWAY STE 1
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NY
Practice Address - Zip Code:10533-1246
Practice Address - Country:US
Practice Address - Phone:914-591-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115335-01172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker