Healthcare Provider Details

I. General information

NPI: 1356170526
Provider Name (Legal Business Name): JENNIFER LOMBARDO LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 N FRONT ST
PHILADELPHIA PA
19122-4661
US

IV. Provider business mailing address

1600 S 10TH ST APT 1R
PHILADELPHIA PA
19148-1102
US

V. Phone/Fax

Practice location:
  • Phone: 267-682-8351
  • Fax:
Mailing address:
  • Phone: 631-835-6959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSW140152
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW026871
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: