Healthcare Provider Details

I. General information

NPI: 1821503301
Provider Name (Legal Business Name): JENA GARROW MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2017
Last Update Date: 10/29/2021
Certification Date: 10/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 SW FEDERAL HWY STE 200B
STUART FL
34994-2972
US

IV. Provider business mailing address

759 SW FEDERAL HWY STE 200B
STUART FL
34994-2972
US

V. Phone/Fax

Practice location:
  • Phone: 561-358-5081
  • Fax:
Mailing address:
  • Phone: 561-358-5081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH15474
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: