Healthcare Provider Details

I. General information

NPI: 1649617648
Provider Name (Legal Business Name): JADE NATALIA PAS-JENSEN LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3722 SPOKANE AVE
CLEVELAND OH
44109-3830
US

IV. Provider business mailing address

3722 SPOKANE AVE
CLEVELAND OH
44109-3830
US

V. Phone/Fax

Practice location:
  • Phone: 216-210-4859
  • Fax:
Mailing address:
  • Phone: 216-210-4859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1500997-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: