Organization Active NPI

Benevolent Therapy LLC

  • Clinical Social Worker
  • Toledo, OH
National Provider Identifier
1760201461
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BENEVOLENT THERAPY LLC
Practice address
3454 Oak Alley CT Ste 214
Toledo, OH 43606-1370
Phone
(419) 740-1836
NPI assigned
Oct 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Jessica Jambor, LISWNPI 1083197123
Title
Owner
Phone
(419) 341-8728

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

3454 Oak Alley CT Ste 214
Toledo, OH 43606-1370

Mailing address

3454 Oak Alley CT Ste 214
Toledo, OH 43606-1370
Phone (419) 740-1836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250207002373 OH Part B Supplier - Clinic/Group Practice 9234669086 Receives reassigned benefits from 1 practitioner
Practice locations: Toledo, OH

National Provider Directory

National Provider Directory

Locations

3775 Truman Rd
Perrysburg, OH 43551

3454 Oak Alley Ct
Ste 214
Toledo, OH 43606
Phone (419) 536-9670

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1760201461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3454 OAK ALLEY CT STE 214",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061370",
            "telephone_number": "419-740-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3454 OAK ALLEY CT STE 214",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061370",
            "telephone_number": "419-740-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENEVOLENT THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "JAMBOR",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-341-8728",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.