Provider Demographics
NPI:1346887106
Name:RADEMACHER, JENNIFER A (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:RADEMACHER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 BAYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GLEN CARBON
Mailing Address - State:IL
Mailing Address - Zip Code:62034-2980
Mailing Address - Country:US
Mailing Address - Phone:618-977-9494
Mailing Address - Fax:
Practice Address - Street 1:13317 COUNTY HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:VENEDY
Practice Address - State:IL
Practice Address - Zip Code:62214-1103
Practice Address - Country:US
Practice Address - Phone:618-317-1537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-28
Last Update Date:2019-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical