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NPI Code Detail

MEDICARE: JENNFIER KNIGHT LISW

MEDICARE: JENNFIER KNIGHT LISW
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 WorkerI.2102674OH

General Provider Information

NPI Number : 1801257027
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNFIER KNIGHT LISW
Provider Business Mailing Address
First Line : 5209 TORRINGTON AVE # 1
Second Line :
City : PARMA
State : OH
Zip : 44134-2177
Country : US
Telephone Number : 703-215-8573
Fax Number :
Provider Business Practice Location Address
First Line : 6100 OAK TREE BLVD STE 200
Second Line :
City : INDEPENDENCE
State : OH
Zip : 44131-6914
Country : US
Telephone Number : 703-215-8573
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2016
Last Update Date : 01/20/2023

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Directions to “ JENNFIER KNIGHT LISW” Practice Location

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