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General NPI Number Information
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NPI Number | 1801485859
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Entity Type | Organization
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Legal Business Name | JESSICA EVANS, LISW-S, LLC
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Dates
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Enumeration Date | 01/14/2021
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Last Update Date | 01/14/2021
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Provider Practice Location Address
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Address Line | 92 NORTHWOODS BLVD STE C1
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City | COLUMBUS
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State | OH
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Zip | 43235-4720
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Country | US
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Telephone | 513-907-1277
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Fax |
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Provider Business Mailing Address
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Address Line | 343 E WELCH AVE
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City | COLUMBUS
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State | OH
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Zip | 43207-1222
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Country | US
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Telephone | 513-907-1277
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA EVANS
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Credential | LISW-S
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Telephone | 513-907-1277
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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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