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NPI Code Detail

MEDICARE: JAIDEN ALLOY LSW

MEDICARE: JAIDEN ALLOY LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2104100000XSocial WorkerS.2512712OH

General Provider Information

NPI Number : 1285568774
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAIDEN ALLOY LSW
Provider Business Mailing Address
First Line : 5400 MONTGOMERY SQUARE DR APT M
Second Line :
City : DAYTON
State : OH
Zip : 45440-2925
Country : US
Telephone Number : 937-403-7661
Fax Number :
Provider Business Practice Location Address
First Line : 765 N DETROIT ST
Second Line :
City : XENIA
State : OH
Zip : 45385-1960
Country : US
Telephone Number : 866-534-2639
Fax Number : 800-480-7578
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2026
Last Update Date : 06/10/2026

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Directions to “ JAIDEN ALLOY LSW” Practice Location

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