Provider Demographics
NPI:1730842410
Name:JENNA BOGETTI MENTAL HEALTH COUNSELING
Entity type:Organization
Organization Name:JENNA BOGETTI MENTAL HEALTH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGETTI
Authorized Official - Suffix:
Authorized Official - Credentials:PC
Authorized Official - Phone:914-494-4430
Mailing Address - Street 1:669 MAIN ST UNIT 143
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-7101
Mailing Address - Country:US
Mailing Address - Phone:914-494-4430
Mailing Address - Fax:
Practice Address - Street 1:552 W LAKE DR STE 4
Practice Address - Street 2:
Practice Address - City:MONTAUK
Practice Address - State:NY
Practice Address - Zip Code:11954-5494
Practice Address - Country:US
Practice Address - Phone:914-494-4430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty