Provider Demographics
NPI:1114802667
Name:MENZL, JASMINE NICOLE ADRIENNE (LSW)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:NICOLE ADRIENNE
Last Name:MENZL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:JASMINI
Other - Middle Name:
Other - Last Name:MENZL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSW
Mailing Address - Street 1:30 GLADE RUN DR
Mailing Address - Street 2:
Mailing Address - City:ZELIENOPLE
Mailing Address - State:PA
Mailing Address - Zip Code:16063-2200
Mailing Address - Country:US
Mailing Address - Phone:724-452-4453
Mailing Address - Fax:
Practice Address - Street 1:30 GLADE RUN DR
Practice Address - Street 2:
Practice Address - City:ZELIENOPLE
Practice Address - State:PA
Practice Address - Zip Code:16063-2200
Practice Address - Country:US
Practice Address - Phone:724-452-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker