Provider Demographics
NPI:1629638150
Name:BAME, JESSA NICOLE (MSW)
Entity type:Individual
Prefix:MISS
First Name:JESSA
Middle Name:NICOLE
Last Name:BAME
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4529 SCHOOLHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-1005
Mailing Address - Country:US
Mailing Address - Phone:513-934-6800
Mailing Address - Fax:513-752-9181
Practice Address - Street 1:919 S 2ND AVE
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4114
Practice Address - Country:US
Practice Address - Phone:509-529-6036
Practice Address - Fax:509-529-6038
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical