Janet McCracken, LCSW

Individual provider Active NPI Clinical Social Worker · Jacksboro, TN

NPI 1104954650 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1104954650
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
4681020 (TN)
Practice address
507 Main St
Jacksboro, TN 37757-2967
Phone
(423) 562-1156
Fax
(423) 566-5106
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4681020TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health of East Tennessee, Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4681020 TN Yes

Addresses

Primary practice location

507 Main St
Jacksboro, TN 37757-2967

Mailing address

2315 Jacksboro Pike
La Follette, TN 37766-2906
Phone (423) 562-4190

Other providers in Jacksboro, TN

All providers in Jacksboro, TN · Clinical Social Worker in Tennessee

Sources for this page

Verify at the official NPI Registry.