| Jennifer Frieswick Msw Lcsw Llc | |
|
37 Coach Line Dr O Fallon MO 63368-8103 | |
| (636) 293-9296 | |
| Not Available |
| Full Name | Jennifer Frieswick Msw Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 37 Coach Line Dr, O Fallon, Missouri |
| Authorized Official Name and Position | Victoria Shepherd (ADMINISTRATOR) |
| Authorized Official Contact | 3143155148 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Frieswick Msw Lcsw Llc 37 Coach Line Dr O Fallon MO 63368-8103 Ph: (636) 293-9296 | Jennifer Frieswick Msw Lcsw Llc 37 Coach Line Dr O Fallon MO 63368-8103 Ph: (636) 293-9296 |
| NPI Number | 1104581057 |
|---|---|
| Provider Enumeration Date | 11/05/2021 |
| Last Update Date | 01/24/2022 |
| Certification Date | 01/24/2022 |
| Medicare PECOS PAC ID | 7315338654 |
|---|---|
| Medicare Enrollment ID | O20211222000337 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104581057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer Frieswick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134884083 PECOS PAC ID: 8224429568 Enrollment ID: I20211222000374 |
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