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Jonathan Revai Fenton, CPSS
Peer Specialist in Utica, New York
NPI 1275244758

Jonathan Revai Fenton is a Peer Specialist based in Utica, NY. Jonathan Revai Fenton practices in Utica, NY and has the professional credentials of CPSS. The NPI Number for Jonathan Revai Fenton is 1275244758 and holds a License No. (New York).

The current practice location address for Jonathan Revai Fenton is 624 Elizabeth St, Utica, NY and can be reached out via phone at 315-939-3176.

Location: 624 Elizabeth St, Utica, NY, 13501-2413
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1275244758
Provider Name
Jonathan Revai Fenton
Credential
CPSS
Provider Entity Type
Individual
Gender
Male
Address
624 Elizabeth St, Utica, NY, 13501-2413
Phone Number
315-939-3176
Fax Number
Provider Enumeration Date
12/06/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
NYCPS-2152 01 NY NYS PEER SUPPORT SPECIALIST
institution
Provider Business Practice Location Address Details
Address
624 Elizabeth St
City
Utica
State
New York
Zip
13501-2413
Phone Number
315-939-3176
Fax Number
person
Provider Business Mailing Address Details
Address
624 Elizabeth St
City
Utica
State
New York
Zip
13501-2413
Phone Number
315-939-3176
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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