MEDICARE: JENNIFER JUNE STRAYER LCSW

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	2408-M	AR
2	1041C0700X	Clinical Social Worker	3816-C	AR

General Provider Information

NPI Number	:	1285993808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER JUNE STRAYER LCSW

Provider Business Mailing Address
First Line	:	1920 MAIN ST
Second Line	:	#223
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72114-2872
Country	:	US
Telephone Number	:	501-313-1507
Fax Number	:

Provider Business Practice Location Address
First Line	:	1920 MAIN ST
Second Line	:	#223
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72114-2872
Country	:	US
Telephone Number	:	501-313-1507
Fax Number	:

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

Provider Enumeration Date	:	05/16/2012
Last Update Date	:	03/27/2017

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