Provider Demographics
NPI:1457597791
Name:KRZYNOWEK, JENNIFER L (LSW)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:L
Last Name:KRZYNOWEK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 LAKESIDE AVE E
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-1129
Mailing Address - Country:US
Mailing Address - Phone:216-241-8230
Mailing Address - Fax:216-587-6726
Practice Address - Street 1:1275 LAKESIDE AVE E
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-1129
Practice Address - Country:US
Practice Address - Phone:216-241-8230
Practice Address - Fax:216-587-6726
Is Sole Proprietor?:No
Enumeration Date:2008-12-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
OHS08000407104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker