Provider Demographics
NPI:1992937924
Name:WARNER, JENNIFER MAGYN (LCSW, LICSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:MAGYN
Last Name:WARNER
Suffix:
Gender:F
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3270 N LAKE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3956
Mailing Address - Country:US
Mailing Address - Phone:917-648-5390
Mailing Address - Fax:971-200-2395
Practice Address - Street 1:3270 N LAKE SHORE DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3956
Practice Address - Country:US
Practice Address - Phone:917-648-5390
Practice Address - Fax:971-200-2395
Is Sole Proprietor?:No
Enumeration Date:2009-08-08
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW607274551041C0700X
ORL65571041C0700X
NY080003-11041C0700X
IL1490231871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical