MEDICARE: CYNTHIA ANN JENNINGS 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	104100000X	Social Worker	1846	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1846	OTHER	SC	LMSW LICENSE NUMBER

General Provider Information

NPI Number	:	1801132675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA ANN JENNINGS LMSW

Provider Business Mailing Address
First Line	:	35 HIDDEN BAY DR
Second Line	:
City	:	SUMTER
State	:	SC
Zip	:	29154-4705
Country	:	US
Telephone Number	:	803-469-7862
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 HIDDEN BAY DR
Second Line	:
City	:	SUMTER
State	:	SC
Zip	:	29154-4705
Country	:	US
Telephone Number	:	803-469-7862
Fax Number	:

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

Provider Enumeration Date	:	12/21/2012
Last Update Date	:	12/21/2012

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