Provider Demographics
NPI:1922241298
Name:SITZER, JENNY GARRETSON (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:GARRETSON
Last Name:SITZER
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 1:1046 FAULKNER TER
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-6060
Mailing Address - Country:US
Mailing Address - Phone:513-288-2727
Mailing Address - Fax:
Practice Address - Street 1:1046 FAULKNER TER
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-6060
Practice Address - Country:US
Practice Address - Phone:513-288-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490133101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL322860003Medicare PIN