Provider Demographics
NPI:1720964877
Name:NEMETH, JACQUELYNE (MHC)
Entity type:Individual
Prefix:
First Name:JACQUELYNE
Middle Name:
Last Name:NEMETH
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WINTHROP CT APT D
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-5613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:924 HOMESTEAD AVE
Practice Address - Street 2:
Practice Address - City:MAYBROOK
Practice Address - State:NY
Practice Address - Zip Code:12543-1312
Practice Address - Country:US
Practice Address - Phone:845-706-0229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP133556101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health