Healthcare Provider Details

I. General information

NPI: 1114848900
Provider Name (Legal Business Name): JENNIFER A LIROT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E MAIN ST STE 201
VAN WERT OH
45891-1757
US

IV. Provider business mailing address

401 E MARKET ST
CELINA OH
45822-1736
US

V. Phone/Fax

Practice location:
  • Phone: 419-584-5123
  • Fax:
Mailing address:
  • Phone: 419-584-5123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2605170-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: