Declercq, Jamie

Declercq, Jamie is an individual health care provider with primary practice located at 924 N Cable Rd , Lima OH 45805-1704. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Declercq, Jamie can be contacted via phone (419) 969-3125.

Contact Information

Primary practice address
924 N Cable Rd Lima OH 45805-1704
Phone: (419) 969-3125
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X I0031486-SUPV Ohio

Profile Details

NPI number 1366734279
LBN Legal business name Declercq, Jamie
Credentials LISW-SUPV
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2011
Last updated Mar 17th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366734279 NPPES
Ohio MEDICAID 0251480

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