Jacqueline Carr, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I8314 Issued in OH

Practice address

511 Perry St
Defiance, OH 43512-2123

Phone

(419) 782-9920

Fax

(419) 784-2523

NPI assigned

May 8, 2007

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Foundations Behavioral Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Celina, OH
  • NPI 1336118330

  OH

  Medicare reassignment NPD
• Recovery Services of Northwest Ohio, Inc

  • Clinic/Center
  • Defiance, OH
  • NPI 1720046451

  OH

  Medicare reassignment NPD
• Antonia Jensen & Associates, LLC

  • Clinical Social Worker
  • Wauseon, OH
  • NPI 1093772733

  Clinical

  NPD (past)

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/rsnwo/r4/

• Jacqueline Harter Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 16, 2016.

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1003029968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 PERRY ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122123",
            "telephone_number": "419-782-9920",
            "fax_number": "419-784-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 PERRY ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122123",
            "telephone_number": "419-782-9920",
            "fax_number": "419-784-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "JACQUELINE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I8314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "HARTER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Marie Cameron
• Sabryn M Camp
• Samantha Campbell, LPN
• Madelyn Carnahan, MS, RDN, LD
• Lavona L Carpenter
• Adolf O Casillas, RPH
• Joshua Glenn Cass
• Teya Castillo
• Brittany Casto, LPN
• Robert Cerniglia, CCDCI

• All providers in Defiance, OH
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.