MEDICARE: MRS. JENNIFER FROMAN 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	C11847	MS

General Provider Information

NPI Number	:	1548115892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER FROMAN LCSW

Provider Business Mailing Address
First Line	:	5215 OLD HIGHWAY 11 STE 70
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-7999
Country	:	US
Telephone Number	:	601-549-2300
Fax Number	:

Provider Business Practice Location Address
First Line	:	5215 OLD HIGHWAY 11 STE 70
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-7999
Country	:	US
Telephone Number	:	601-549-2300
Fax Number	:

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/10/2026

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