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JENNICA LAINE-FORMISANO PSYD
NPI 1093454159
Clinic/Center - Mental Health (Including Community Mental Health Center) in Kingston, NY

Active since May 27, 2022
260 KINGS MALL CT # 331, KINGSTON, NY 12401(845) 489-3687(845) 332-6041 Get Directions Write a Review

NPPES record last updated: May 27, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jennica Laine-formisano Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNICA LAINE-FORMISANO PSYD (NPI 1093454159) is a healthcare organization registered as a mental health (including community mental health center) in Kingston, New York and active in the NPI registry since May 2022. The organization lists Jennica Laine-formisano, Owner, as its authorized official.

NPPES Registry Identity

NPI1093454159
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameJENNICA LAINE-FORMISANO PSYD
Location Address260 KINGS MALL CT # 331Kingston, NY 12401-1574
Mailing Address260 Kings Mall Ct # 331Kingston, NY 12401-1574 · (845) 489-3687 · Fax (845) 332-6041
Phone(845) 489-3687
Fax(845) 332-6041
Organization SubpartNo
Authorized OfficialJennica Laine-formisanoOwner · (845) 489-3687
Enumeration DateMay 27, 2022
NPPES CertifiedMay 26, 2022
✔ NPI 1093454159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
260 KINGS MALL CT # 331, Kingston, NY 12401
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JENNICA LAINE-FORMISANO PSY.D.
Psychologist (Clinical)
260 KINGS MALL CT # 331
KINGSTON, NY 12401
Ulster County (845) 489-3687

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennica Laine-Formisano Psyd's NPI number?

The NPI number for Jennica Laine-Formisano Psyd is 1093454159. It was assigned to this organization in the NPPES registry on May 27, 2022.

Where is Jennica Laine-Formisano Psyd located?

Jennica Laine-Formisano Psyd is located at 260 Kings Mall Ct # 331, Kingston, NY 12401. The listed phone number is (845) 489-3687.

What is Jennica Laine-Formisano Psyd's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Jennica Laine-Formisano Psyd was last updated on May 27, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.