Provider Demographics
NPI:1346369550
Name:SCARLETT, JEAN M (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:M
Last Name:SCARLETT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 FAIRWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-6628
Mailing Address - Country:US
Mailing Address - Phone:937-859-0468
Mailing Address - Fax:
Practice Address - Street 1:627 S EDWIN C MOSES BLVD
Practice Address - Street 2:EAST MEDICAL PLAZA 6TH FLOOR
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45408-1461
Practice Address - Country:US
Practice Address - Phone:937-461-9150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010811371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical