Provider Demographics
NPI:1730998295
Name:DR. LAUREN JESSELL, LCSW, PHD
Entity type:Organization
Organization Name:DR. LAUREN JESSELL, LCSW, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:JESSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-886-2909
Mailing Address - Street 1:286 5TH AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-4512
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:286 5TH AVE STE 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4512
Practice Address - Country:US
Practice Address - Phone:914-713-5418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. LAUREN JESSELL, LCSW, PHD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-30
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty