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General NPI Number Information
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NPI Number | 1841443884
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Entity Type | Individual
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Provider Name | JENNIFER OVERTON LCSW, LMSW-C
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Gender | Female
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Dates
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Enumeration Date | 11/03/2008
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Last Update Date | 09/05/2021
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Provider Practice Location Address
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Address Line | 120 E FRONT ST STE 2
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-2668
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Country | US
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Telephone | 231-256-1167
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 482
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City | EMPIRE
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State | MI
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Zip | 49630-0482
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Country | US
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Telephone | 231-256-1167
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Fax | 231-525-2147
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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 | 6801101892
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License Number State | MI
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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 | 14139
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License Number State | SC
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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 | C007266
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License Number State | NC
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