MEDICARE: JESSICA GAYLE MCFARLING

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	101YP2500X	Professional Counselor
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1215304985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JESSICA GAYLE MCFARLING

Provider Business Mailing Address
First Line	:	720 SE 1ST ST
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47713-1104
Country	:	US
Telephone Number	:	270-929-1762
Fax Number	:	833-812-0155

Provider Business Practice Location Address
First Line	:	1727 SWEENEY ST STE 104
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42303-3834
Country	:	US
Telephone Number	:	270-929-1762
Fax Number	:	833-812-0155

Authorized Official
Title or Position	:	CLINICAL SOCIAL WORKER
Name	:	MS. JESSICA GAYLE MCFARLING
Credential	:	LCSW
Telephone Number	:	270-929-1762

Provider Enumeration Date	:	08/28/2015
Last Update Date	:	11/10/2020

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