Provider Demographics
NPI:1275178501
Name:FILO, JENIFER RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:RENEE
Last Name:FILO
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 1:15426 S 300 W
Mailing Address - Street 2:
Mailing Address - City:HANNA
Mailing Address - State:IN
Mailing Address - Zip Code:46340-9616
Mailing Address - Country:US
Mailing Address - Phone:219-608-5003
Mailing Address - Fax:
Practice Address - Street 1:1229 ARROWHEAD CT
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-8222
Practice Address - Country:US
Practice Address - Phone:219-661-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004668A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical