Provider Demographics
NPI:1225797533
Name:WARD, JENNI LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNI
Middle Name:LEE
Last Name:WARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 SHADY GLEN DR
Mailing Address - Street 2:
Mailing Address - City:GREENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18426-7470
Mailing Address - Country:US
Mailing Address - Phone:570-972-9377
Mailing Address - Fax:
Practice Address - Street 1:116 SHADY GLEN DR
Practice Address - Street 2:
Practice Address - City:GREENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18426-7470
Practice Address - Country:US
Practice Address - Phone:570-972-9377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CW0241591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical