Provider Demographics
NPI:1326277468
Name:WELLS, JAMIE MICHELLE (LISW-S)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:MICHELLE
Last Name:WELLS
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N 7TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-2244
Mailing Address - Country:US
Mailing Address - Phone:740-374-6338
Mailing Address - Fax:740-374-6066
Practice Address - Street 1:210 N 7TH ST STE 200
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-2244
Practice Address - Country:US
Practice Address - Phone:740-374-6338
Practice Address - Fax:740-374-6066
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 00296361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH08258Medicaid