Provider Demographics
NPI:1831138973
Name:KERR, JEAN HARVEY (MSW)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:HARVEY
Last Name:KERR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4417 HANSFORD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-1188
Mailing Address - Country:US
Mailing Address - Phone:252-937-7732
Mailing Address - Fax:252-937-7981
Practice Address - Street 1:3701B SUNSET AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3327
Practice Address - Country:US
Practice Address - Phone:252-937-7732
Practice Address - Fax:252-937-7981
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0033601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003068Medicaid
NC137F4OtherBCBS