Provider Demographics
NPI:1518521574
Name:MINGIONE JANSEN, KARENSA LYN (LMHC)
Entity type:Individual
Prefix:
First Name:KARENSA
Middle Name:LYN
Last Name:MINGIONE JANSEN
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:KARENSA
Other - Middle Name:
Other - Last Name:MINGIONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:707 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2650
Mailing Address - Country:US
Mailing Address - Phone:845-333-8909
Mailing Address - Fax:
Practice Address - Street 1:68 HARRIS BUSHVILLE ROAD
Practice Address - Street 2:
Practice Address - City:HARRIS
Practice Address - State:NY
Practice Address - Zip Code:12742
Practice Address - Country:US
Practice Address - Phone:845-333-8909
Practice Address - Fax:845-333-6980
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010821-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07593199Medicaid