Provider Demographics
NPI:1083019152
Name:SCHMOYER, JESSIE (LISW)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:
Last Name:SCHMOYER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4653 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-3298
Mailing Address - Country:US
Mailing Address - Phone:614-384-7798
Mailing Address - Fax:614-384-7703
Practice Address - Street 1:4653 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-3298
Practice Address - Country:US
Practice Address - Phone:614-384-7798
Practice Address - Fax:614-384-7703
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-30
Last Update Date:2022-04-14
Deactivation Date:2017-11-01
Deactivation Code:
Reactivation Date:2018-03-27
Provider Licenses
StateLicense IDTaxonomies
OHI.22034331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical