Healthcare Provider Details

I. General information

NPI: 1235054412
Provider Name (Legal Business Name): JENNIFER LYNN DOWNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7454 US RT. 50 WEST
BAINBRIDGE OH
45612
US

IV. Provider business mailing address

7454 US RT. 50 WEST
BAINBRIDGE OH
45612
US

V. Phone/Fax

Practice location:
  • Phone: 740-634-2826
  • Fax:
Mailing address:
  • Phone: 740-634-2826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.02022
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: