Provider Demographics
NPI:1972823565
Name:HAGERTY, JENNIFER L (MSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:HAGERTY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:SPRINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13712 RIVERCREST DR
Mailing Address - Street 2:
Mailing Address - City:WHITE PIGEON
Mailing Address - State:MI
Mailing Address - Zip Code:49099-8133
Mailing Address - Country:US
Mailing Address - Phone:269-816-3334
Mailing Address - Fax:269-273-0607
Practice Address - Street 1:13712 RIVERCREST DR
Practice Address - Street 2:
Practice Address - City:WHITE PIGEON
Practice Address - State:MI
Practice Address - Zip Code:49099-8133
Practice Address - Country:US
Practice Address - Phone:269-816-3334
Practice Address - Fax:269-273-0607
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010904351041C0700X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor