Provider Demographics
NPI:1245891381
Name:COLLINS, JODI KEMPNER (LISW-S)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:KEMPNER
Last Name:COLLINS
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 1:350 ASHWORTH CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1355
Mailing Address - Country:US
Mailing Address - Phone:614-633-7812
Mailing Address - Fax:
Practice Address - Street 1:3962 N HAMPTON DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-8430
Practice Address - Country:US
Practice Address - Phone:614-633-7812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI1100002.SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical