Provider Demographics
NPI:1063175305
Name:PIERCE, JENNIFER R (LISW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:R
Last Name:PIERCE
Suffix:
Gender:
Credentials:LISW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:REBEKAH
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-257-3760
Mailing Address - Fax:614-257-3148
Practice Address - Street 1:181 TAYLOR AVE FL 2
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1779
Practice Address - Country:US
Practice Address - Phone:614-257-3760
Practice Address - Fax:614-257-3148
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2405228104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty