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

Last updated

Mar 16, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Harter Former name

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/

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

• Foundations Behavioral Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Celina, OH
  • NPI 1336118330
  Medicare reassignment NPD
• Recovery Services of Northwest Ohio, Inc

  • Clinic/Center
  • Defiance, OH
  • NPI 1720046451
  Medicare reassignment NPD
• Antonia Jensen & Associates, LLC

  dba aja Behavioral

  • Clinical Social Worker
  • Wauseon, OH
  • NPI 1093772733
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "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

• Clinical Social Worker in Defiance, OH
• Providers in Defiance, OH by specialty
• 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.