MEDICARE: JENNIFER LYNN CROMER 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	104100000X	Social Worker	254949	KY
2	1041C0700X	Clinical Social Worker	LCSW00001367	KY

General Provider Information

NPI Number	:	1467070763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LYNN CROMER LCSW

Provider Business Mailing Address
First Line	:	600 US 31W BYP STE 12
Second Line	:
City	:	BOWLING GREEN
State	:	KY
Zip	:	42101-4905
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1310 24TH AVE S
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-2637
Country	:	US
Telephone Number	:	629-259-1871
Fax Number	:

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

Provider Enumeration Date	:	07/13/2020
Last Update Date	:	02/03/2026

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