Jackson Richard Fay, LSW, BSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.1904009 Issued in OH

Practice address

1624 Tiffin Ave Ste a
Findlay, OH 45840-6852

Phone

(419) 427-3320

Fax

(419) 427-1697

NPI assigned

Aug 27, 2018

Sex

Male

Sole proprietor

Yes

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.

• Specialized Alternatives for Families and Youth of Ohio, Inc.

  • Community/Behavioral Health Agency
  • Lima, OH
  • NPI 1447216718
  NPD (past)

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1750862819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 ELIDA RD",
            "city": "DELPHOS",
            "state": "OH",
            "postal_code": "458339056",
            "telephone_number": "419-697-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 TIFFIN AVE STE A",
            "city": "FINDLAY",
            "state": "OH",
            "postal_code": "458406852",
            "telephone_number": "419-427-3320",
            "fax_number": "419-427-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAY",
        "first_name": "JACKSON",
        "middle_name": "RICHARD",
        "credential": "LSW, BSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-27",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1904009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Medical Associates of Findlay, Inc
• Family Resource Center of Northwest Ohio Inc
• Jamie Ann Farrell, OCPSRA
• Draeton Fasone
• Peter Fass, M.D.
• William Fedirka
• Timothy Michael Feeney, DDS
• Leslie J Felter, OT
• Jodi Ferdinandsen Smaltz
• Tahrima Ferdous, MD

• Social Worker in Findlay, OH
• Providers in Findlay, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.