Provider Demographics
NPI:1598298788
Name:BOROVICA, JENNIFER (LISW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BOROVICA
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15620 DETROIT AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3708
Mailing Address - Country:US
Mailing Address - Phone:216-385-8050
Mailing Address - Fax:
Practice Address - Street 1:15620 DETROIT AVE STE 108
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-3708
Practice Address - Country:US
Practice Address - Phone:216-385-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14512221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0328455Medicaid