Active NPI
Jennifer Damm
- Mental Health Counselor
- Tiffin, OH
National Provider Identifier
1164401485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- E0003749
- Practice address
- 300 Melmore St
Tiffin, OH 44883-3535 - Phone
- (419) 447-8111
- Fax
- (419) 447-8158
- NPI assigned
- Jan 13, 2006
- Last updated
- Dec 10, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | E0003749 | OH | Primary |
Addresses
Primary practice location
300 Melmore St
Tiffin, OH 44883-3535
Mailing address
300 Melmore St
P.O. Box 713
Tiffin, OH 44883-3535
Phone (419) 447-8111
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 |
|---|---|---|---|
| E0003749 | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christian Counseling Center at First Lutheran Church | Past | Accepting new patients | |
| Counseling Connections Center LLC | Mental Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Professional Counselor
- Tiffin, OH
- NPI 1073788618
-
- Mental Health Counselor
- Tiffin, OH
- NPI 1831728229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260403200000",
"number": "1164401485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 MELMORE ST",
"address_2": "P.O. BOX 713",
"city": "TIFFIN",
"state": "OH",
"postal_code": "448833535",
"telephone_number": "419-447-8111",
"fax_number": "419-447-8158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 MELMORE ST",
"city": "TIFFIN",
"state": "OH",
"postal_code": "448833535",
"telephone_number": "419-447-8111",
"fax_number": "419-447-8158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAMM",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-13",
"last_updated": "2009-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E0003749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tiffin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.