Provider Demographics
NPI:1497803076
Name:JARREL, ANN O (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:O
Last Name:JARREL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 BELMEAD LN
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-7839
Mailing Address - Country:US
Mailing Address - Phone:903-509-9398
Mailing Address - Fax:866-399-2809
Practice Address - Street 1:2624 KENSINGTON DR STE 109
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-2734
Practice Address - Country:US
Practice Address - Phone:903-509-9398
Practice Address - Fax:866-399-2809
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS128931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3927LCOtherBCBS
TX116243003Medicaid