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NPI Code Detail

MEDICARE: JANE ESTES LCSW

MEDICARE: JANE ESTES 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 Worker

General Provider Information

NPI Number : 1659319572
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE ESTES LCSW
Provider Business Mailing Address
First Line : PO BOX 1589
Second Line :
City : BENTON
State : AR
Zip : 72018-1589
Country : US
Telephone Number : 501-315-3344
Fax Number :
Provider Business Practice Location Address
First Line : 522 MILL RD
Second Line :
City : CLARKSVILLE
State : AR
Zip : 72830-8511
Country : US
Telephone Number : 501-315-3344
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2006
Last Update Date : 07/08/2007

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