Provider Demographics
NPI:1720866205
Name:MESSENGER, JAMIE (MSW, LSW, LICDC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:MESSENGER
Suffix:
Gender:F
Credentials:MSW, LSW, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1374 YELLOWSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-3724
Mailing Address - Country:US
Mailing Address - Phone:330-329-9648
Mailing Address - Fax:
Practice Address - Street 1:111 STOW AVE STE 100
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-2560
Practice Address - Country:US
Practice Address - Phone:234-334-3132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH162401101YA0400X
OH2208490104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty