Provider Demographics
NPI:1720228919
Name:ZERFOWSKI, JENNIFER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:ZERFOWSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:MCCAULEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1135 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT ZION
Mailing Address - State:IL
Mailing Address - Zip Code:62549-1046
Mailing Address - Country:US
Mailing Address - Phone:217-207-0041
Mailing Address - Fax:217-207-0042
Practice Address - Street 1:5130 HICKORY POINT FRONTAGE RD STE 230
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-9773
Practice Address - Country:US
Practice Address - Phone:217-207-0041
Practice Address - Fax:217-207-0042
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-27
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.011938104100000X
IL149.0156921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker