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General NPI Number Information
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NPI Number | 1558018911
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Entity Type | Individual
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Provider Name | JENNIFER A DENEEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/07/2022
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 2181 ORANGE AVE E
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City | TALLAHASSEE
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State | FL
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Zip | 32311-6144
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Country | US
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Telephone | 850-878-0191
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Fax |
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Provider Business Mailing Address
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Address Line | 2999 BROCKTON CT
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City | MISHAWAKA
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State | IN
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Zip | 46545-3837
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Country | US
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Telephone | 269-357-6187
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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 | 6801098455
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34009439A
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License Number State | IN
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