Active NPI
Jessica S Datta, LSW
- Clinical Social Worker
- Perrysburg, OH
National Provider Identifier
1003113150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- S0027641
- Practice address
- 975 Commerce Dr
Perrysburg, OH 43551-5228 - Phone
- (419) 874-0274
- Fax
- (419) 874-9960
- NPI assigned
- Feb 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | S0027641 | OH | Primary |
Addresses
Primary practice location
975 Commerce Dr
Perrysburg, OH 43551-5228
Mailing address
975 Commerce Dr
Perrysburg, OH 43551-5228
Phone (419) 874-0274
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S0027641 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298505600000",
"number": "1003113150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "975 COMMERCE DR",
"city": "PERRYSBURG",
"state": "OH",
"postal_code": "435515228",
"telephone_number": "419-874-0274",
"fax_number": "419-874-9960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 COMMERCE DR",
"city": "PERRYSBURG",
"state": "OH",
"postal_code": "435515228",
"telephone_number": "419-874-0274",
"fax_number": "419-874-9960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DATTA",
"first_name": "JESSICA",
"middle_name": "S",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-24",
"last_updated": "2011-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "S0027641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perrysburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.