Provider Demographics
NPI:1578193439
Name:FLYNN, JENNA KAY HAMILL (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:KAY HAMILL
Last Name:FLYNN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:KAY
Other - Last Name:HAMILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW, CBIS
Mailing Address - Street 1:209 BELL ARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6120
Mailing Address - Country:US
Mailing Address - Phone:919-244-2279
Mailing Address - Fax:
Practice Address - Street 1:5121 KINGDOM WAY STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6063
Practice Address - Country:US
Practice Address - Phone:919-743-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-20
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0119201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical