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Search › New York › 1041C0700X

Jessica Fanning, LCSW

NPI 1336636570 · on the registry since 2018 · sole proprietor

Practice

Address
11 Route 111
Smithtown, NY 11787
Phone
(631) 920-8376
Organisation at this address
New Horizons
Pederson Krag Center
The Pederson Krag Center
Inferred from a shared address, not stated in the registry.
Clinicians at this address
173

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Also registered as
104100000X
Licence states on file
NY
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2024-02-06

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York