1073557971 NPI number — MS. JENNIFER HOPE ZENZ-OLSON MSW LICSW

Table of content: MS. JENNIFER HOPE ZENZ-OLSON MSW LICSW (NPI 1073557971)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073557971 NPI number — MS. JENNIFER HOPE ZENZ-OLSON MSW LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZENZ-OLSON
Provider First Name:
JENNIFER
Provider Middle Name:
HOPE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZENZ
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
H
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1073557971
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7850 RIVERDALE DR
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
RAMSEY
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-427-2590
Provider Business Mailing Address Fax Number:
763-427-2579

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7850 RIVERDALE DR
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
RAMSEY
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-427-2590
Provider Business Practice Location Address Fax Number:
763-427-2579
Provider Enumeration Date:
06/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  15372 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 652640300 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 922241040453 . This is a "PREFERRED ONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: HP40390 . This is a "HEALTH PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 103943C851 . This is a "UCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 309K02E . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




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