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NPI Code Detail

MEDICARE: MS. JENNIFER BARNETT POLEN L.C.S.W.

MEDICARE:  MS. JENNIFER BARNETT POLEN  L.C.S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCW017523PA

General Provider Information

NPI Number : 1043650583
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER BARNETT POLEN L.C.S.W.
Provider Business Mailing Address
First Line : 5619 VINE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19139-1302
Country : US
Telephone Number : 215-471-2761
Fax Number :
Provider Business Practice Location Address
First Line : 5619 VINE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19139-1302
Country : US
Telephone Number : 215-471-2761
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2013
Last Update Date : 06/28/2013

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Directions to “ MS. JENNIFER BARNETT POLEN L.C.S.W.” Practice Location

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