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NPI Code Detail

MEDICARE: JENNIFER LANZA-LINN M.A. LPCC-S, ATR

MEDICARE: JENNIFER LANZA-LINN M.A. LPCC-S, ATR
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
1101YP2500XProfessional CounselorE.0900076-SUPVOH

General Provider Information

NPI Number : 1437429628
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LANZA-LINN M.A. LPCC-S, ATR
Provider Business Mailing Address
First Line : 11102 STATE ROUTE 700
Second Line :
City : GARRETTSVILLE
State : OH
Zip : 44231-9202
Country : US
Telephone Number : 330-261-3054
Fax Number :
Provider Business Practice Location Address
First Line : 12041 RAVENNA RD
Second Line :
City : CHARDON
State : OH
Zip : 44024-7008
Country : US
Telephone Number : 440-286-7154
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2012
Last Update Date : 11/03/2016

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