Provider Demographics
NPI:1386985778
Name:SCHROLL, JENNIE (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIE
Middle Name:
Last Name:SCHROLL
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:PO BOX 671866
Mailing Address - Street 2:
Mailing Address - City:CHUGIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99567-1866
Mailing Address - Country:US
Mailing Address - Phone:907-691-4528
Mailing Address - Fax:
Practice Address - Street 1:24813 FASSLER CIR
Practice Address - Street 2:
Practice Address - City:CHUGIAK
Practice Address - State:AK
Practice Address - Zip Code:99567-5767
Practice Address - Country:US
Practice Address - Phone:907-980-0628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-08
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKCSW12831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical