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NPI Code Detail

MEDICARE: MISS JENNIFER MCCARRON LMSW

MEDICARE: MISS JENNIFER MCCARRON LMSW
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
1104100000XSocial WorkerAR

General Provider Information

NPI Number : 1265631303
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JENNIFER MCCARRON LMSW
Provider Business Mailing Address
First Line : 2 CEDAR BRANCH DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72223-2361
Country : US
Telephone Number : 501-221-3936
Fax Number :
Provider Business Practice Location Address
First Line : 2411 W MAIN ST
Second Line :
City : JACKSONVILLE
State : AR
Zip : 72076-4211
Country : US
Telephone Number : 501-982-5402
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2007
Last Update Date : 07/17/2007

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