Provider Demographics
NPI:1528107232
Name:ZARE, JENNIFER ELYSE (LISW-CP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ELYSE
Last Name:ZARE
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 TRAILSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-3322
Mailing Address - Country:US
Mailing Address - Phone:864-561-1133
Mailing Address - Fax:864-288-0501
Practice Address - Street 1:3 WINCHESTER CT
Practice Address - Street 2:
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-2626
Practice Address - Country:US
Practice Address - Phone:854-561-1133
Practice Address - Fax:864-288-0501
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8403104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker