Jerisel Jimenez, LCSW
Social Worker, Clinical in New York, NY. Individual provider (NPI-1).
NPI number1053958652
StatusActive
Last updated in NPPESApr 2, 2026
Details
- NPI
- 1053958652
- Entity type
- Individual (NPI-1)
- Name
- Jerisel Jimenez
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 3, 2019
- Certification date
- Apr 2, 2026
- Last updated
- Apr 2, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 095123 | NY | Yes |
| 104100000X | Social Worker | 107620 | NY |
Practice location
291 Broadway Rm 1002New York, NY 10007-1883
Phone 646-300-5952
Mailing address
291 BroadwayNew York, NY 10007-1814
Phone 646-300-5952
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