MEDICARE: AFTON RAYE JENNINGS LCSW, C-SSWS

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	LCSW-1095	WY

General Provider Information

NPI Number	:	1871487538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AFTON RAYE JENNINGS LCSW, C-SSWS

Provider Business Mailing Address
First Line	:	4524 S SKYLINE RD
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82604-9283
Country	:	US
Telephone Number	:	307-259-9797
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 WERNER CT STE 145
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-1323
Country	:	US
Telephone Number	:	307-259-9797
Fax Number	:

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

Provider Enumeration Date	:	06/06/2025
Last Update Date	:	06/06/2025

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