Individual provider Active NPI

Jennifer Yvonne Garross, LCSW

  • Clinical Social Worker
  • Flower Mound, TX
National Provider Identifier
1972102200
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
59266 Issued in TX
Practice address
1509 Colony St
Flower Mound, TX 75028-2504
Phone
(214) 709-2020
NPI assigned
Oct 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 59266 TX Primary

Addresses

Primary practice location

1509 Colony St
Flower Mound, TX 75028-2504

Mailing address

1509 Colony St
Flower Mound, TX 75028-2504
Phone (214) 709-2020

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
59266TXMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1972102200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 COLONY ST",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282504",
            "telephone_number": "214-709-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 COLONY ST",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282504",
            "telephone_number": "214-709-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARROSS",
        "first_name": "JENNIFER",
        "middle_name": "YVONNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "59266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.