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NPI Code Detail

MEDICARE: DR. JENNIFER KING DSW, LISW

MEDICARE:  DR. JENNIFER  KING  DSW, LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerI.1100012OH
21041C0700XClinical Social WorkerCW017018PA

General Provider Information

NPI Number : 1184913915
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER KING DSW, LISW
Provider Business Mailing Address
First Line : 4506 COLLEGE RD
Second Line :
City : SOUTH EUCLID
State : OH
Zip : 44121-4229
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 29055 CLEMENS RD
Second Line : SUITE A
City : WESTLAKE
State : OH
Zip : 44145-1135
Country : US
Telephone Number : 440-250-9880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2011
Last Update Date : 06/24/2015

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Directions to “ DR. JENNIFER KING DSW, LISW” Practice Location

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