Provider Demographics
NPI:1356327324
Name:KAY, JENNIFER (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:KAY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 NE 98TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2472
Mailing Address - Country:US
Mailing Address - Phone:305-758-8388
Mailing Address - Fax:305-757-4518
Practice Address - Street 1:640 NE 98TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2472
Practice Address - Country:US
Practice Address - Phone:305-758-8388
Practice Address - Fax:305-757-4518
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW444811103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ7926Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER