Provider Demographics
NPI:1013568419
Name:PRETTY, JOSLYNN ELIZABETH (MA, CDCA)
Entity type:Individual
Prefix:MRS
First Name:JOSLYNN
Middle Name:ELIZABETH
Last Name:PRETTY
Suffix:
Gender:F
Credentials:MA, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 BAVARIAN ST APT B
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-5448
Mailing Address - Country:US
Mailing Address - Phone:513-567-0900
Mailing Address - Fax:
Practice Address - Street 1:110 BAVARIAN ST APT B
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-5448
Practice Address - Country:US
Practice Address - Phone:513-567-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OH09312832183700000X
OHCDCA.188501101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0374351Medicaid