MEDICARE: JENNIFER NANCY PEARSON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	67898	TX

General Provider Information

NPI Number	:	1225725641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER NANCY PEARSON LCSW

Provider Business Mailing Address
First Line	:	835 E LAMAR BLVD # 420
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-3504
Country	:	US
Telephone Number	:	817-900-2251
Fax Number	:

Provider Business Practice Location Address
First Line	:	5150 TRAIL LAKE DR STE 5
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-2030
Country	:	US
Telephone Number	:	817-900-2251
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2023
Last Update Date	:	09/29/2025

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