MEDICARE: JENNIFER ANN SCOTT M.S.W.

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	1041C0700X	Clinical Social Worker	2013033735	MO

General Provider Information

NPI Number	:	1255632428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ANN SCOTT M.S.W.

Provider Business Mailing Address
First Line	:	5727 WINONA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63109-1565
Country	:	US
Telephone Number	:	314-346-8299
Fax Number	:

Provider Business Practice Location Address
First Line	:	1902 ARSENAL ST STE 240
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-2503
Country	:	US
Telephone Number	:	314-346-8299
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2010
Last Update Date	:	01/04/2019

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