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DR. JENNICA LAINE-FORMISANO PSY.D.
NPI 1346587862
Psychologist - Clinical in Kingston, NY

Active since January 04, 2013
260 KINGS MALL CT # 331, KINGSTON, NY 12401(845) 489-3687 Get Directions Write a Review

NPPES record last updated: May 7, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 7, 2021, Apr 14, 2018, Sep 2, 2016 (3 updates tracked since 2016).

About Dr. Jennica Laine-formisano Psy.d. NPPES

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

DR. JENNICA LAINE-FORMISANO PSY.D. (NPI 1346587862) is an individual clinical provider in Kingston, New York, licensed in New York (021267-1) and active in the NPI registry since January 2013. She maintains 2 additional practice locations.

NPPES Registry Identity

NPI1346587862
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. JENNICA LAINE-FORMISANOCredential: PSY.D.
Location Address260 KINGS MALL CT # 331Kingston, NY 12401-1574
Mailing Address148 Burt StSaugerties, NY 12477-1907 · (845) 489-3687
Phone(845) 489-3687
Sole ProprietorYes
Enumeration DateJanuary 4, 2013
Last NPPES UpdateMay 7, 20213 updates tracked since enumeration
NPPES CertifiedMay 7, 2021
✔ NPI 1346587862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in NY · 021267-1
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
260 KINGS MALL CT # 331, Kingston, NY 12401
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Secondary Practice Locations 2

Location 120 Milton AveHighland, NY 12528-1415 · Phone (845) 489-3687
Location 2148 Burt StSaugerties, NY 12477-1907 · Phone (845) 489-3687

Other Providers at the Same Location NPPES

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

JENNICA LAINE-FORMISANO PSYD
Clinic/Center (Mental Health (Including Community Mental Health Center))
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's NPI number?

The NPI number for Jennica Laine-formisano is 1346587862. It was assigned to this individual provider in the NPPES registry on January 4, 2013.

Where is Jennica Laine-formisano located?

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

What is Jennica Laine-formisano's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Jennica Laine-formisano was last updated on May 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.