| Jason L Griner Lcsw Pc | |
|
2914 N Oak St Valdosta GA 31602-1718 | |
| (229) 333-0300 | |
| (229) 333-0306 |
| Full Name | Jason L Griner Lcsw Pc |
|---|---|
| Speciality | Social Worker |
| Location | 2914 N Oak St, Valdosta, Georgia |
| Authorized Official Name and Position | Jason La Ron Griner (CEO) |
| Authorized Official Contact | 2292510264 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jason L Griner Lcsw Pc 1267 Rountree Bridge Rd. Sparks GA 31647-6423 Ph: (229) 251-0264 | Jason L Griner Lcsw Pc 2914 N Oak St Valdosta GA 31602-1718 Ph: (229) 333-0300 |
| NPI Number | 1699382556 |
|---|---|
| Provider Enumeration Date | 09/24/2020 |
| Last Update Date | 09/24/2020 |
| Certification Date | 09/23/2020 |
| Medicare PECOS PAC ID | 6204247497 |
|---|---|
| Medicare Enrollment ID | O20201119000086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699382556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jason L Griner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497146641 PECOS PAC ID: 9133447675 Enrollment ID: I20150414001473 |
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