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NPI Code Detail

MEDICARE: BEVERLY KATHRYN JENNINGS LCSW

MEDICARE: BEVERLY KATHRYN JENNINGS 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
11041C0700XClinical Social Worker149029836IL

General Provider Information

NPI Number : 1427368216
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEVERLY KATHRYN JENNINGS LCSW
Provider Business Mailing Address
First Line : 1025 MAINE ST
Second Line :
City : QUINCY
State : IL
Zip : 62301-4096
Country : US
Telephone Number : 217-222-6550
Fax Number : 217-277-2253
Provider Business Practice Location Address
First Line : 873 GROVE ST
Second Line :
City : JACKSONVILLE
State : IL
Zip : 62650-2828
Country : US
Telephone Number : 217-479-3400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2010
Last Update Date : 02/09/2026

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