MEDICARE: JESSICA L SONGER QMHS CMS

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	171M00000X	Case Manager/Care Coordinator		OH
2	172V00000X	Community Health Worker		OH
3	101Y00000X	Counselor	CDCA.166289	OH

General Provider Information

NPI Number	:	1558837690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA L SONGER QMHS CMS

Provider Business Mailing Address
First Line	:	3909 WOODLEY RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-1169
Country	:	US
Telephone Number	:	419-725-3330
Fax Number	:

Provider Business Practice Location Address
First Line	:	2173 N RIDGE RD E STE E
Second Line	:
City	:	LORAIN
State	:	OH
Zip	:	44055-3400
Country	:	US
Telephone Number	:	440-260-8300
Fax Number	:

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

Provider Enumeration Date	:	10/16/2018
Last Update Date	:	05/13/2026

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