Jesse Ayers, LCSW

Individual provider Active NPI Clinical Social Worker · South Pittsburg, TN

NPI 1174258669 · NPPES record last updated Jul 19, 2022

Key facts

NPI
1174258669
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
8084 (TN)
Practice address
211 12TH Street West
South Pittsburg, TN 37380
Phone
(931) 308-4220
NPI assigned
Jul 19, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
8084TNMDPublic Health Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8084 TN Yes

Addresses

Primary practice location

211 12TH Street West
South Pittsburg, TN 37380

Mailing address

211 12TH Street West
South Pittsburg, TN 37380

Other providers in South Pittsburg, TN

All providers in South Pittsburg, TN · Clinical Social Worker in Tennessee

Sources for this page

Verify at the official NPI Registry.