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NPI Code Detail

MEDICARE: MS. JERI HUGHES SQUYRES LCSW

MEDICARE: MS. JERI HUGHES SQUYRES 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
11041C0700XClinical Social Worker0904002956VA

General Provider Information

NPI Number : 1538107164
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JERI HUGHES SQUYRES LCSW
Provider Business Mailing Address
First Line : 809 CANEBREAK DR
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-6836
Country : US
Telephone Number : 228-523-5000
Fax Number : 228-523-4628
Provider Business Practice Location Address
First Line : 2279 ATKINSON RD
Second Line :
City : BILOXI
State : MS
Zip : 39531-2209
Country : US
Telephone Number : 228-865-1330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2006
Last Update Date : 10/31/2022

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