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General NPI Number Information
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NPI Number | 1194865378
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Entity Type | Individual
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Provider Name | JERRI LYNN FROST LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 03/09/2025
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Provider Practice Location Address
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Address Line | 110 PARKER AVE S
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City | BROOKLET
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State | GA
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Zip | 30415-8208
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Country | US
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Telephone | 706-490-2555
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Fax | 912-823-4232
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Provider Business Mailing Address
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Address Line | PO BOX 2
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City | BROOKLET
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State | GA
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Zip | 30415-0002
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Country | US
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Telephone | 706-490-2555
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW 003122
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License Number State | GA
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