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General NPI Number Information
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NPI Number | 1275178501
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Entity Type | Individual
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Provider Name | JENIFER RENEE FILO LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/11/2019
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Last Update Date | 11/11/2019
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Provider Practice Location Address
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Address Line | 1229 ARROWHEAD CT
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City | CROWN POINT
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State | IN
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Zip | 46307-8222
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Country | US
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Telephone | 219-661-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 15426 S 300 W
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City | HANNA
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State | IN
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Zip | 46340-9616
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Country | US
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Telephone | 219-608-5003
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34004668A
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License Number State | IN
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