Provider Demographics
NPI:1538760236
Name:GJINI, JOANNA (LP-MHC)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:GJINI
Suffix:
Gender:F
Credentials:LP-MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 S RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-5123
Mailing Address - Country:US
Mailing Address - Phone:845-204-1980
Mailing Address - Fax:
Practice Address - Street 1:44 MAIN ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3828
Practice Address - Country:US
Practice Address - Phone:845-481-0065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-08
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty