Healthcare Provider Details

I. General information

NPI: 1801709183
Provider Name (Legal Business Name): JESSICA DOZIER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 W 8TH ST
MISHAWAKA IN
46544-4921
US

IV. Provider business mailing address

718 W 8TH ST
MISHAWAKA IN
46544-4921
US

V. Phone/Fax

Practice location:
  • Phone: 574-276-6489
  • Fax:
Mailing address:
  • Phone: 574-276-6489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34013219A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: