Healthcare Provider Details

I. General information

NPI: 1245099043
Provider Name (Legal Business Name): JADEAN FROST LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2024
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2981 MONTANA AVE
CINCINNATI OH
45211-6706
US

IV. Provider business mailing address

2651 BURNET AVE
CINCINNATI OH
45219-2551
US

V. Phone/Fax

Practice location:
  • Phone: 513-363-5900
  • Fax:
Mailing address:
  • Phone: 513-363-0123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2310196
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: