Provider Demographics
NPI:1851887491
Name:SCHREIBER, JENNIFER (BSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:SCHREIBER
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 THORNBERRY DR STE B
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-1600
Mailing Address - Country:US
Mailing Address - Phone:270-825-1698
Mailing Address - Fax:270-825-8050
Practice Address - Street 1:1079 THORNBERRY DR STE B
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-1600
Practice Address - Country:US
Practice Address - Phone:270-825-1698
Practice Address - Fax:270-825-8050
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC$$$$$$$$$Medicaid