Provider Demographics
NPI:1063183887
Name:LANZAS, JENNIFER (LCSW)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:LANZAS
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 1:18495 S DIXIE HWY STE 318
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6817
Mailing Address - Country:US
Mailing Address - Phone:888-318-4788
Mailing Address - Fax:888-318-4788
Practice Address - Street 1:18495 S DIXIE HWY STE 318
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-6817
Practice Address - Country:US
Practice Address - Phone:888-318-4788
Practice Address - Fax:888-318-4788
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW174111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical