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General NPI Number Information
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NPI Number | 1477361491
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Entity Type | Organization
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Legal Business Name | J.C. WELLNESS SOLUTIONS, LLC
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 201 W CHARLES ST
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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 | 419-617-5840
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 106
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City | BUCYRUS
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State | OH
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Zip | 44820-0106
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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 | CLINICAL SOCIAL WORKER/OWNER
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Name | MRS. JACQUELINE CHRISTINE CARVER
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Credential | MSW, LISW-S
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Telephone | 419-617-9173
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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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