Gavin, Jared David

Gavin, Jared David is an individual health care provider with primary practice located at 501 S Jupiter Rd , Garland TX 75042-7108. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Gavin, Jared David can be contacted via phone (214) 997-3359.

Contact Information

Primary practice address
501 S Jupiter Rd Garland TX 75042-7108
Phone: (214) 997-3359
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 3607 Nebraska
Behavioral Health & Social Service Providers / Clinical 1041C0700X 105496 Texas
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1339 Nebraska

Profile Details

NPI number 1356480487
LBN Legal business name Gavin, Jared David
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356480487 NPPES
Nebraska MEDICAID 520111977

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