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NPI Code Detail

MEDICARE: JENNA B. EDWARDS LISW

MEDICARE: JENNA B. EDWARDS 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.2103200OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861874307
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA B. EDWARDS LISW
Provider Business Mailing Address
First Line : 4400 EASTON CMNS STE 125
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-6223
Country : US
Telephone Number : 554-438-8331
Fax Number :
Provider Business Practice Location Address
First Line : 4400 EASTON CMNS STE 125
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-6223
Country : US
Telephone Number : 855-438-8331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2015
Last Update Date : 08/05/2025

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Directions to “ JENNA B. EDWARDS LISW” Practice Location

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