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NPI Code Detail

MEDICARE: JENNIFER LYNN RYCZKO EKLUND MSW, LISW-CP, CDP

MEDICARE:   JENNIFER LYNN RYCZKO EKLUND  MSW, LISW-CP, CDP
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 Worker
21041C0700XClinical Social Worker11898SC

General Provider Information

NPI Number : 1700175023
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LYNN RYCZKO EKLUND MSW, LISW-CP, CDP
Provider Business Mailing Address
First Line : 1316 CAROL OAKS DR
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29466-6501
Country : US
Telephone Number : 614-205-2659
Fax Number :
Provider Business Practice Location Address
First Line : 1316 CAROL OAKS DR
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29466-6501
Country : US
Telephone Number : 614-205-2659
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2011
Last Update Date : 07/21/2021

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Directions to “ JENNIFER LYNN RYCZKO EKLUND MSW, LISW-CP, CDP” Practice Location

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