Jaime N Fogarty, LSW

Individual provider Active NPI Clinical Social Worker · Wauseon, OH

NPI 1720749237 · NPPES record last updated Jan 6, 2022

Key facts

NPI
1720749237
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
850 W Elm St
Wauseon, OH 43567-1189
Phone
(567) 343-6068
Fax
(413) 254-6065
NPI assigned
Jan 6, 2022
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Joy D Fruchey and Associates Clinical Current
since May 1, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Yes

Addresses

Primary practice location

850 W Elm St
Wauseon, OH 43567-1189

Mailing address

PO Box 293
Wauseon, OH 43567-0293
Phone (567) 343-6068

Other providers in Wauseon, OH

All providers in Wauseon, OH · Clinical Social Worker in Ohio

Sources for this page

Verify at the official NPI Registry.