| Jennifer Grant Lmsw Llc | |
|
569 Wildwood Ave Ste 6 Jackson MI 49201-1048 | |
| (517) 206-9749 | |
| Not Available |
| Full Name | Jennifer Grant Lmsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 569 Wildwood Ave Ste 6, Jackson, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Grant Lmsw Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Jennifer Grant Lmsw Llc 569 Wildwood Ave Ste 6 Jackson MI 49201-1048 Ph: (517) 206-9749 |
| NPI Number | 1417733379 |
|---|---|
| Provider Enumeration Date | 09/06/2023 |
| Last Update Date | 09/06/2023 |
| Certification Date | 09/06/2023 |
| Medicare PECOS PAC ID | 3678937570 |
|---|---|
| Medicare Enrollment ID | O20230911004039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417733379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Jennifer Grant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487920591 PECOS PAC ID: 0143504159 Enrollment ID: I20170310000437 |
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