Individual
JENNIE STATCZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1170 OLD HENDERSON RD STE 100, COLUMBUS, OH 43220-3623
(614) 442-7650
Mailing address
1170 OLD HENDERSON RD STE 100, COLUMBUS, OH 43220-3623
(614) 442-7650
(614) 442-7656
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C.2002647
OH
390200000X
Student in an Organized Health Care Education/Training Program
C.1801397-TRNE
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473276
—
OH
Enumeration date
07/11/2019
Last updated
05/28/2020
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