Provider Demographics
NPI:1225595622
Name:DEVINS, JAMES J JR
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:DEVINS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 BENNETT RD
Mailing Address - Street 2:
Mailing Address - City:MINFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45653-8958
Mailing Address - Country:US
Mailing Address - Phone:317-750-3608
Mailing Address - Fax:
Practice Address - Street 1:1724 ST RT 728
Practice Address - Street 2:
Practice Address - City:LUCASVILLE
Practice Address - State:OH
Practice Address - Zip Code:45699-0001
Practice Address - Country:US
Practice Address - Phone:740-259-5544
Practice Address - Fax:740-259-2882
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.18009641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty