Provider Demographics
NPI:1104684828
Name:LEWANCZYK-TERENZIO, JENNIFER AGNES (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:AGNES
Last Name:LEWANCZYK-TERENZIO
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 1:1630 RED COACH LN
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-3961
Mailing Address - Country:US
Mailing Address - Phone:773-983-9306
Mailing Address - Fax:
Practice Address - Street 1:477 E BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5618
Practice Address - Country:US
Practice Address - Phone:872-228-7243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0267091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical