Organization Active NPI

Monica Jay, MSW, Lisw-S, LLC

  • Clinical Social Worker
  • Fremont, OH
National Provider Identifier
1043676646
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I. 0800149 Issued in OH
Legal business name
MONICA JAY, MSW, LISW-S, LLC
Practice address
317 Birchard Ave
Fremont, OH 43420-3011
Phone
(419) 680-0937
Fax
(567) 249-0067
NPI assigned
Jan 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Authorized official

Name
Monica Jay, MSW, LISW-SNPI 1235376823
Title
Clinical Therapist
Phone
(419) 680-0937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X I. 0800149 OH Primary

Addresses

Primary practice location

317 Birchard Ave
Fremont, OH 43420-3011

Mailing address

317 Birchard Ave
Fremont, OH 43420-3011
Phone (419) 680-0937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250718000769 OH Part B Supplier - Clinic/Group Practice 5395251292 Receives reassigned benefits from 2 practitioners
Practice locations: Fremont, OH

National Provider Directory

National Provider Directory

Locations

317 Birchard Ave
Fremont, OH 43420
Phone (419) 680-0937

6000 Renaissance Pl
Toledo, OH 43623
Phone (419) 882-3388

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1043676646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 BIRCHARD AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434203011",
            "telephone_number": "419-680-0937",
            "fax_number": "567-249-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 BIRCHARD AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434203011",
            "telephone_number": "419-680-0937",
            "fax_number": "567-249-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONICA JAY, MSW, LISW-S, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-12",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "JAY",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "419-680-0937",
        "authorized_official_credential": "MSW, LISW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I. 0800149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.