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General NPI Number Information
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NPI Number | 1356480487
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Entity Type | Individual
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Provider Name | JARED DAVID GAVIN LCSW
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Gender | Male
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 6851 VIRGINIA PKWY STE 211
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City | MCKINNEY
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State | TX
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Zip | 75071-5637
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Country | US
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Telephone | 214-997-3359
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Fax |
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Provider Business Mailing Address
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Address Line | 949 WHITEHALL DR
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City | PLANO
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State | TX
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Zip | 75023-6736
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Country | US
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Telephone | 214-814-4788
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3607
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 105496
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1339
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License Number State | NE
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