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Provider Information for 1932326816


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Mrs. JENNIFER LYNN PIESTER LCSW


Other Names:  
Former Name: 
Miss JENNIFER LYNN OWENS LCSW

Sex: Female

NPI: 1932326816
Last Updated: 2023-07-11
Certification Date: 2023-07-11

Details

NameValue
NPI1932326816
Enumeration Date2007-04-20
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 4320 WINFIELD RD STE 200
WARRENVILLE, IL 60555-4023
United States

Phone: 630-410-9587 | Fax:
 
Primary Practice Address 4602 3RD ST
MOLINE, IL 61265-6106
United States

Phone: 309-779-2823 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)IL370984175BWAY INC FEIN
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YM0800X - Counselor - Mental HealthIL370984175
Yes 1041C0700X - Social Worker - ClinicalIL149012500