Individual
JEANIE WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8626 AIRWAYS BLVD, SOUTHAVEN, MS 38671-2603
(662) 772-5937
(662) 772-5940
Mailing address
8626 AIRWAYS BLVD, SOUTHAVEN, MS 38671-2603
(662) 772-5937
(662) 772-5940
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6286
TN
1041C0700X
Clinical Social Worker
Primary
C-10834
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q019510
—
TN
Enumeration date
09/03/2008
Last updated
12/05/2025
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