Renda, Jacqueline Lucille

Renda, Jacqueline Lucille is an individual health care provider with primary practice located at 210 Emerson St , Port Jefferson NY 11777-1605. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / School is her primary health care specialty. Renda, Jacqueline Lucille can be contacted via phone (631) 331-3895.

Contact Information

Primary practice address
210 Emerson St Port Jefferson NY 11777-1605
Phone: (631) 331-3895
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X R039200-1 New York
Behavioral Health & Social Service Providers / School 1041S0200X R039200-1 New York

Profile Details

NPI number 1700087434
LBN Legal business name Renda, Jacqueline Lucille
Credentials LCSW-R
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2007
Last updated Sep 11th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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