Provider Demographics
NPI:1841584455
Name:JAROS, JACQUELINE (LISW, LCSW)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:JAROS
Suffix:
Gender:F
Credentials:LISW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9999 GRANGER RD STE 2
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-5319
Mailing Address - Country:US
Mailing Address - Phone:440-487-7013
Mailing Address - Fax:216-478-0122
Practice Address - Street 1:9999 GRANGER RD STE 2
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125
Practice Address - Country:US
Practice Address - Phone:440-487-7013
Practice Address - Fax:216-478-0122
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI08002371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical