Provider Demographics
NPI:1861953572
Name:HOV, JEREMY DANIEL (MSW, CSWA)
Entity type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:DANIEL
Last Name:HOV
Suffix:
Gender:M
Credentials:MSW, CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4210 NE 140TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-6946
Mailing Address - Country:US
Mailing Address - Phone:503-810-2733
Mailing Address - Fax:360-905-1738
Practice Address - Street 1:1601 E FOURTH PLAIN BLVD BLDG 18
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3717
Practice Address - Country:US
Practice Address - Phone:360-696-4061
Practice Address - Fax:360-905-1738
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA53841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical