Provider Demographics
NPI:1801100664
Name:HOMAN, JESSE BARRINGTON (MS)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:BARRINGTON
Last Name:HOMAN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1649 ROBINSON CIR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45223-1511
Mailing Address - Country:US
Mailing Address - Phone:310-866-1166
Mailing Address - Fax:
Practice Address - Street 1:2142 ALPINE PL
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-3214
Practice Address - Country:US
Practice Address - Phone:503-395-4267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health