Provider Demographics
NPI:1942736137
Name:SCHWEITZER, JENNIFER (LGSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SCHWEITZER
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SILVER LAKE RD NW UNIT 201
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-8108
Mailing Address - Country:US
Mailing Address - Phone:612-206-1332
Mailing Address - Fax:
Practice Address - Street 1:151 SILVER LAKE RD NW UNIT 201
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-8108
Practice Address - Country:US
Practice Address - Phone:612-206-1332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-07
Last Update Date:2017-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN23705104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker