MEDICARE: DANIELLE JENNINGS

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	7192	KY
2	1041C0700X	Clinical Social Worker	254328	KY

General Provider Information

NPI Number	:	1720528862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE JENNINGS

Provider Business Mailing Address
First Line	:	114 E REYNOLDS RD STE 202
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40517-1248
Country	:	US
Telephone Number	:	859-203-8878
Fax Number	:

Provider Business Practice Location Address
First Line	:	114 E REYNOLDS RD STE 202
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40517-1248
Country	:	US
Telephone Number	:	859-203-8878
Fax Number	:

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

Provider Enumeration Date	:	03/07/2017
Last Update Date	:	01/21/2026

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Directions to “ DANIELLE JENNINGS ” Practice Location

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