MEDICARE: JENNIFER CONSTANOS LCSW

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	1041C0700X	Clinical Social Worker	083237	NY
2	1041C0700X	Clinical Social Worker	CW022084	PA

General Provider Information

NPI Number	:	1841882727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER CONSTANOS LCSW

Provider Business Mailing Address
First Line	:	951 VIEWMONT DR # 1008
Second Line	:
City	:	DICKSON CITY
State	:	PA
Zip	:	18519-1663
Country	:	US
Telephone Number	:	716-217-9441
Fax Number	:

Provider Business Practice Location Address
First Line	:	951 VIEWMONT DR # 1008
Second Line	:
City	:	DICKSON CITY
State	:	PA
Zip	:	18519-1663
Country	:	US
Telephone Number	:	716-217-9441
Fax Number	:

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

Provider Enumeration Date	:	02/11/2021
Last Update Date	:	03/18/2025

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