Provider Demographics
NPI:1538219142
Name:YOXTHIMER, JENNIFER CRITCHLEY (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:CRITCHLEY
Last Name:YOXTHIMER
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 WHITEHALL RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12209-1128
Mailing Address - Country:US
Mailing Address - Phone:518-421-1674
Mailing Address - Fax:
Practice Address - Street 1:251 NEW KARNER RD
Practice Address - Street 2:SUITE 19
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-4617
Practice Address - Country:US
Practice Address - Phone:518-421-1674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072107-R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical