Healthcare Provider Details

I. General information

NPI: 1902604150
Provider Name (Legal Business Name): JESSICA CARR BSSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2233 ROCKY LN
ASHLAND OH
44805-4701
US

IV. Provider business mailing address

270 SANDUSKY ST
ASHLAND OH
44805-2033
US

V. Phone/Fax

Practice location:
  • Phone: 419-281-3716
  • Fax: 419-281-4605
Mailing address:
  • Phone: 419-281-3788
  • Fax: 877-277-3297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2613478
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: