Provider Demographics
NPI:1942587878
Name:JAHN, CHRISTINE L (MSW, LSW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:L
Last Name:JAHN
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 N ENGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-9744
Mailing Address - Country:US
Mailing Address - Phone:765-361-9767
Mailing Address - Fax:
Practice Address - Street 1:701 N ENGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-9744
Practice Address - Country:US
Practice Address - Phone:765-361-9767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-06
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33005587A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker