Julissa J Coblentz

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S.1501187 Issued in OH

Practice address

10 S Clay St Ste 101
Millersburg, OH 44654-1329

Phone

(330) 275-0573

NPI assigned

Mar 1, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Family Life Counseling & Psychiatric Services

  • Addiction (Substance Use Disorder) Counselor
  • Mansfield, OH
  • NPI 1669731246
  NPD (past)

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1720672876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 FORLOW ST",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446541001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S CLAY ST STE 101",
            "city": "MILLERSBURG",
            "state": "OH",
            "postal_code": "446541329",
            "telephone_number": "330-275-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBLENTZ",
        "first_name": "JULISSA",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1501187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chaffee Family Chiro Inc (39 Chiropractic & Rehabilitation)
• Brayden Chaney
• Tina M Chase
• Catherine E Chew
• Emily Josephine Clark
• Hudson Kenneth Cole, DPT
• Holly C Conway, OD
• James R Conway, OD
• William M Cox, MD
• Randall Scott Crawford, RPH

• Clinical Social Worker in Millersburg, OH
• Providers in Millersburg, 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 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.