Provider Demographics
NPI:1700448537
Name:JAMES, JAMIE MICHELLE (LSW S 0031207)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:MICHELLE
Last Name:JAMES
Suffix:
Gender:F
Credentials:LSW S 0031207
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:WINTERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953-4037
Mailing Address - Country:US
Mailing Address - Phone:740-632-4450
Mailing Address - Fax:
Practice Address - Street 1:703 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953-4037
Practice Address - Country:US
Practice Address - Phone:740-632-4450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0031207104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker