Healthcare Provider Details

I. General information

NPI: 1003589953
Provider Name (Legal Business Name): JENNA TUREK LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1757 INDIAN WOOD CIR
MAUMEE OH
43537-4009
US

IV. Provider business mailing address

10461 MILL RUN CIR STE 810
OWINGS MILLS MD
21117-5549
US

V. Phone/Fax

Practice location:
  • Phone: 866-688-6917
  • Fax:
Mailing address:
  • Phone: 410-807-8471
  • Fax: 410-525-5560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2411332
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: