Healthcare Provider Details

I. General information

NPI: 1891619607
Provider Name (Legal Business Name): JESSICA MONROY CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1326 W 9TH ST
OWENSBORO KY
42301-2028
US

IV. Provider business mailing address

4029 CARPENTER DR
OWENSBORO KY
42301-6734
US

V. Phone/Fax

Practice location:
  • Phone: 270-240-1076
  • Fax: 270-240-2154
Mailing address:
  • Phone: 270-240-1076
  • Fax: 270-240-2154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW00001591
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: