Provider Demographics
NPI:1770363012
Name:JARA, BRITNEY D
Entity type:Individual
Prefix:
First Name:BRITNEY
Middle Name:D
Last Name:JARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3523 88TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-5660
Mailing Address - Country:US
Mailing Address - Phone:917-327-3272
Mailing Address - Fax:
Practice Address - Street 1:55 W 39TH ST RM 305
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3830
Practice Address - Country:US
Practice Address - Phone:917-677-9070
Practice Address - Fax:917-725-8044
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP124274101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health