Provider Demographics
NPI:1053079798
Name:SJP THERAPY, LLC
Entity Type:Organization
Organization Name:SJP THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEASE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LISW-S
Authorized Official - Phone:330-506-3981
Mailing Address - Street 1:10999 REED HARTMAN HWY STE 337
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-8303
Mailing Address - Country:US
Mailing Address - Phone:513-788-2357
Mailing Address - Fax:
Practice Address - Street 1:10999 REED HARTMAN HWY STE 337
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-8303
Practice Address - Country:US
Practice Address - Phone:513-788-2357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty