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General NPI Number Information
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NPI Number | 1467120915
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Entity Type | Individual
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Provider Name | JESSICA DIANE MEYER CDCA
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Gender | Female
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Dates
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Enumeration Date | 08/31/2021
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 6601 CENTERVILLE BUSINESS PKWY STE 310
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City | CENTERVILLE
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State | OH
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Zip | 45459-2697
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Country | US
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Telephone | 937-637-6735
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Fax |
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Provider Business Mailing Address
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Address Line | 1681 E DOROTHY LN APT 22
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City | KETTERING
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State | OH
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Zip | 45429-3835
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Country | US
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Telephone | 937-499-0069
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 176041
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | OH
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