Provider Demographics
NPI:1245822576
Name:NEWKIRK, JOCELYN (LSW)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:NEWKIRK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:
Other - Last Name:NEWKIRK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:3215 AUGUST AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-7090
Mailing Address - Country:US
Mailing Address - Phone:513-320-6814
Mailing Address - Fax:
Practice Address - Street 1:3215 AUGUST AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-7090
Practice Address - Country:US
Practice Address - Phone:513-320-6814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-08
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.14300311041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool