MEDICARE: MRS. JENNIFER NICOLE TRUITT LMSW

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	CSW005009	GA

General Provider Information

NPI Number	:	1720268717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER NICOLE TRUITT LMSW

Provider Business Mailing Address
First Line	:	9127 BRANCH VALLEY WAY
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30076-3384
Country	:	US
Telephone Number	:	404-556-1791
Fax Number	:

Provider Business Practice Location Address
First Line	:	3565 PIEDMONT RD NE STE 510
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-8202
Country	:	US
Telephone Number	:	470-284-4889
Fax Number	:

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

Provider Enumeration Date	:	11/07/2007
Last Update Date	:	05/25/2026

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