MEDICARE: JENNIFER LOMBARDO LSW

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
1	101YM0800X	Mental Health Counselor	SW140152	PA
2	1041C0700X	Clinical Social Worker	CW026871	PA

General Provider Information

NPI Number	:	1356170526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LOMBARDO LSW

Provider Business Mailing Address
First Line	:	1600 S 10TH ST APT 1R
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-1102
Country	:	US
Telephone Number	:	631-835-6959
Fax Number	:

Provider Business Practice Location Address
First Line	:	1216 N FRONT ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19122-4661
Country	:	US
Telephone Number	:	267-682-8351
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2024
Last Update Date	:	12/16/2025

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