MEDICARE: JENIFER L YAWGER 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	44SC05533500	NJ

General Provider Information

NPI Number	:	1497411656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENIFER L YAWGER LCSW

Provider Business Mailing Address
First Line	:	86 OMAHA AVE
Second Line	:
City	:	ROCKAWAY
State	:	NJ
Zip	:	07866-1514
Country	:	US
Telephone Number	:	908-295-6751
Fax Number	:

Provider Business Practice Location Address
First Line	:	86 OMAHA AVE
Second Line	:
City	:	ROCKAWAY
State	:	NJ
Zip	:	07866-1514
Country	:	US
Telephone Number	:	908-295-6751
Fax Number	:

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

Provider Enumeration Date	:	11/11/2021
Last Update Date	:	11/11/2021

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