Provider Demographics
NPI:1174115083
Name:POOL, JEANETTE (MSW, LGSW)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:POOL
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 LOUISE AVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-5716
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14 E GRAFTON RD
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-0067
Practice Address - Country:US
Practice Address - Phone:304-366-5832
Practice Address - Fax:304-333-2210
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker