Larry Jeter, is a
Social Worker - Clinical based in Milwaukee, Wisconsin. Larry Jeter is licensed to practice in Wisconsin (license number 561-123) and his current practice location is
4383 N 27th St, Milwaukee, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(414) 871-8883.
NPI number for Larry Jeter is 1366577173 and his current mailing address is 3203 N Sherman Blvd, Milwaukee, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1366577173.
Healthcare Provider's Profile
| Full Name | Larry Jeter |
|---|
| Gender | Male |
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| Speciality | Social Worker - Clinical |
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| Location | 4383 N 27th St, Milwaukee, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1366577173
- Provider Enumeration Date: 02/22/2007
- Last Update Date: 07/09/2007
Medical Identifiers
Medical identifiers for Larry Jeter such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1366577173 | NPI | - | NPPES |
| 39075200 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 12552-131 (Wisconsin) | Primary |
| 1041C0700X | Social Worker - Clinical | 561-123 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Larry Jeter is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Larry Jeter,
3203 N Sherman Blvd,
Milwaukee, WI 53216-3546
Ph: () - | Larry Jeter,
4383 N 27th St,
Milwaukee, WI 53216-1809
Ph: (414) 871-8883 |
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