| Jennifer Lanouette Lcsw | |
|
105 N Virginia Ave Ste 306 Falls Church VA 22046-3342 | |
| (703) 981-9070 | |
| Not Available |
| Full Name | Jennifer Lanouette Lcsw |
|---|---|
| Speciality | Social Worker |
| Location | 105 N Virginia Ave Ste 306, Falls Church, Virginia |
| Authorized Official Name and Position | Jennifer Lanouette (OWNER) |
| Authorized Official Contact | 7039819070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Lanouette Lcsw 304 S Highland St Arlington VA 22204-2054 Ph: (703) 981-9070 | Jennifer Lanouette Lcsw 105 N Virginia Ave Ste 306 Falls Church VA 22046-3342 Ph: (703) 981-9070 |
| NPI Number | 1508581455 |
|---|---|
| Provider Enumeration Date | 10/04/2022 |
| Last Update Date | 10/04/2022 |
| Certification Date | 10/04/2022 |
| Medicare PECOS PAC ID | 6305213588 |
|---|---|
| Medicare Enrollment ID | O20221031002964 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508581455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer G Lanouette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669147765 PECOS PAC ID: 5890191829 Enrollment ID: I20210831000883 |
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