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General NPI Number Information
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NPI Number | 1144142225
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Entity Type | Individual
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Provider Name | ETHAN JACOB LENZNER LMHC
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Gender | Male
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Dates
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Enumeration Date | 07/29/2026
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Last Update Date | 07/29/2026
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Provider Practice Location Address
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Address Line | 2761 MILTON RD
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-7602
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Country | US
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Telephone | 240-207-8382
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Fax | 240-207-8382
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Provider Business Mailing Address
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Address Line | 790 N MILWAUKEE ST STE 300
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City | MILWAUKEE
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State | WI
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Zip | 53202-3712
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Country | US
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Telephone | 240-207-8382
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Fax | 240-207-8382
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | VA
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