MEDICARE: MRS. JESSICA BLYTHE HORVAT LISW

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
1	104100000X	Social Worker	10010148	OH

General Provider Information

NPI Number	:	1447363064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA BLYTHE HORVAT LISW

Provider Business Mailing Address
First Line	:	1408 CROYDEN RD
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-1417
Country	:	US
Telephone Number	:	330-915-2907
Fax Number	:

Provider Business Practice Location Address
First Line	:	12417 CEDAR RD STE 21
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44106-3157
Country	:	US
Telephone Number	:	330-915-2907
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	09/19/2025

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