Healthcare Provider Details

I. General information

NPI: 1154225266
Provider Name (Legal Business Name): JILL LENZMEIER MSW, LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 E 2ND ST STE 110
CHASKA MN
55318-1906
US

IV. Provider business mailing address

102 E 2ND ST
CHASKA MN
55318-1906
US

V. Phone/Fax

Practice location:
  • Phone: 651-262-1415
  • Fax:
Mailing address:
  • Phone: 651-262-1415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number33289
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: