MEDICARE: JACQUELINE MCGREW

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	5314C	AL
2	1041C0700X	Clinical Social Worker	C8099	MS

General Provider Information

NPI Number	:	1801215108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE MCGREW

Provider Business Mailing Address
First Line	:	8117 RUE HOLLIFIELD
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-7567
Country	:	US
Telephone Number	:	601-695-0065
Fax Number	:

Provider Business Practice Location Address
First Line	:	8117 RUE HOLLIFIELD
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-7567
Country	:	US
Telephone Number	:	601-695-0065
Fax Number	:

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

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	07/24/2023

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Directions to “ JACQUELINE MCGREW ” Practice Location

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