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General NPI Number Information
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NPI Number | 1417214032
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Entity Type | Individual
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Provider Name | JACQUELINE C CARVER LISW-S
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Gender | Female
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 201 W CHARLES ST STE B
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City | BUCYRUS
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State | OH
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Zip | 44820-2217
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Country | US
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Telephone | 419-617-1140
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Fax | 419-740-1515
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Provider Business Mailing Address
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Address Line | 3300 STATE ROUTE 61
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City | CRESTLINE
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State | OH
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Zip | 44827-9451
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Country | US
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Telephone | 419-617-9173
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.1201243
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License Number State | OH
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