MEDICARE: JESSICA HORVAT AND ASSOCIATES

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1720731425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JESSICA HORVAT AND ASSOCIATES

Provider Business Mailing Address
First Line	:	1408 CROYDEN RD
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-1417
Country	:	US
Telephone Number	:
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	:	216-288-6560
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	JESSICA HORVAT
Credential	:	LISW-S
Telephone Number	:	216-288-6560

Provider Enumeration Date	:	02/02/2022
Last Update Date	:	02/02/2022

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