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NPI Code Detail

MEDICARE: JENNA GEORGINA PYWELL LCSW

MEDICARE:   JENNA GEORGINA PYWELL  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 Worker64045TX

General Provider Information

NPI Number : 1427825058
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA GEORGINA PYWELL LCSW
Provider Business Mailing Address
First Line : 1705 ANTLER DR
Second Line :
City : AUSTIN
State : TX
Zip : 78741-3718
Country : US
Telephone Number : 512-202-4588
Fax Number :
Provider Business Practice Location Address
First Line : 1705 ANTLER DR
Second Line :
City : AUSTIN
State : TX
Zip : 78741-3718
Country : US
Telephone Number : 512-202-4588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2023
Last Update Date : 12/05/2023

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Directions to “ JENNA GEORGINA PYWELL LCSW” Practice Location

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