Provider Demographics
NPI:1447497755
Name:ZOLDAN, JENNIFER (AUD, LCSW)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:ZOLDAN
Suffix:
Gender:F
Credentials:AUD, LCSW
Other - Prefix:DR
Other - First Name:SHANI
Other - Middle Name:ZOLDAN-
Other - Last Name:VERSCHLEISER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD, LCSW
Mailing Address - Street 1:2772 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-5327
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2772 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-5327
Practice Address - Country:US
Practice Address - Phone:718-408-7233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002087231H00000X
NY089129-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist