Jessica Flores, MSW, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2405484 Issued in OH

Practice address

22251 State Route 2
Archbold, OH 43502-9452

Phone

(419) 445-1552

Fax

(419) 445-1401

NPI assigned

Mar 24, 2016

Last updated

Nov 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH, IN2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shalom Ministries

  dba Shalom Counseling & Mediation Center

  • Community/Behavioral Health Agency
  • Archbold, OH
  • NPI 1366573552
  Medicare reassignment NPD
• Bowen Health Inc

  dba Otis R Bowen Center

  • Adult Mental Health Clinic/Center
  • Warsaw, IN
  • NPI 1639172810
  Medicare reassignment NPD
• Bowen Health Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Wayne, IN
  • NPI 1023668183
  NPD

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

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1508228958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 MIDDLE ST",
            "city": "ARCHBOLD",
            "state": "OH",
            "postal_code": "435021430",
            "telephone_number": "419-822-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22251 STATE ROUTE 2",
            "city": "ARCHBOLD",
            "state": "OH",
            "postal_code": "435029452",
            "telephone_number": "419-445-1552",
            "fax_number": "419-445-1401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 W Central Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436063834",
            "country_code": "US",
            "telephone_number": "419-291-1026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLORES",
        "first_name": "JESSICA",
        "credential": "MSW, LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1600931",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2405484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fairlawn Haven (Fairlawn Haven Assisted Living)
• Kristine Siesel Fauver, ED.D.
• Matthew Christopher Ferguson, M.O.T., OTR/L
• Flame Fitness LLC (Kinesis)
• Jenna Marie Fleming, MOT, OTR
• Fulton Anesthesia Associates Inc
• Kristy Gerig
• Rhonda S Gingerich, MA CCC SLP
• Melanie A Gingrich
• Liza Marie Gleckler

• Clinical Social Worker in Archbold, OH
• Providers in Archbold, 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 Nov 4, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.