Provider Demographics
NPI:1740716554
Name:KANIEWSKI, JENNIFER (LSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:KANIEWSKI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 SHAWNEE RD
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-3583
Mailing Address - Country:US
Mailing Address - Phone:419-999-2010
Mailing Address - Fax:419-999-6284
Practice Address - Street 1:2101 GREENDALE AVE
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-7160
Practice Address - Country:US
Practice Address - Phone:419-422-3978
Practice Address - Fax:419-422-3928
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS 16002871041C0700X
OHS.1600287104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical