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NPI Code Detail

MEDICARE: JENNIFER ROSE GARRIOTT LCSW

MEDICARE: JENNIFER ROSE GARRIOTT 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 WorkerSW19355FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568791549
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER ROSE GARRIOTT LCSW
Provider Business Mailing Address
First Line : 9050 PINES BLVD STE 305
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33024-6422
Country : US
Telephone Number : 630-205-4664
Fax Number :
Provider Business Practice Location Address
First Line : 9050 PINES BLVD STE 305
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33024-6422
Country : US
Telephone Number : 630-205-4664
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2009
Last Update Date : 04/06/2023

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