JACK E WOLFF (NPI# 1265068498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265068498 |
Entity Type | Individual |
Full Name | JACK E WOLFF |
Credential | PEER SUPPORT |
Practice Address |
2934 Carlton Dr Nw Warren OH 44485-1220 |
Practice Telephone | 2348305275 |
Mailing Telephone | 2348305275 |
Enumeration Date | 2020-03-19 |
Last Update Date | 2020-03-19 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 175T00000X | Peer Specialist | Other Service Providers |
Street Address |
2934 CARLTON DR NW |
City | WARREN |
State | OH |
Zip Code | 44485-1220 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780284752 | Heather Lynn Ayres | Technician | 4046 North Leavitt Rd Nw, Warren, OH 44485 | 2020-10-29 |
1730576315 | Jeanetta Chatmon | Community Health Worker | 1447 Kensington St. Nw, Warren, OH 44485 | 2015-04-21 |
1003201351 | Laneka Oliver | Home Health | 1655 Denison Ave, Warren, OH 44485 | 2015-04-03 |
1437401155 | Rhoda Darlene Killingworth | Nurse's Aide | 1510 Arthur Dr Nw, Warren, OH 44485 | 2012-10-04 |
1477844033 | Lakshmi Padmanabhan | Pharmacist | 1560 Parkman Road, Rite Aid Pharmacy, Warren, OH 44485 | 2011-04-29 |
1225332422 | Dashah Brendae Adams | Licensed Practical Nurse | 3270 Dunstan Dr. Nw, Warren, OH 44485 | 2011-01-03 |
1982854188 | Deanna Lynne Nussle | Registered Nurse | 1480 Tod Ave, Warren, OH 44485 | 2008-09-24 |
1003093170 | Kila E Mcghee | Home Health | 1108 Tod Ave Nw, Warren, OH 44485 | 2008-01-30 |
1639372816 | Stella L Reese | Home Health Aide | 1890 Northfield Nw, Attn Karen Morgan, Warren, OH 44485 | 2007-06-06 |
1417016239 | Laura Marie Buck | Counselor | Louis Stokes Cleveland Medical Center, 1406 Tod Ave Nw Warren Va Cboc, Warren, OH 44485 | 2006-12-07 |
Find all providers in zip 44485 |
Taxonomy Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437760493 | Laura Maria Devengencie | Peer Specialist | 3003 Halsey Dr Ne, Warren, OH 44483-5611 | 2020-08-13 |
1114545480 | Cory Lee Wright | Peer Specialist | 419 North St Nw, Warren, OH 44483-3721 | 2020-07-13 |
1417572850 | Kimberly Lee Slater | Peer Specialist | 709 Mahoning Ave Nw, Warren, OH 44483 | 2020-06-11 |
1427697788 | Kristina Ann Bridgens | Peer Specialist | 1916 Clermont Ave Ne, Warren, OH 44483-3524 | 2020-01-03 |
1508404682 | Jerry Silhan | Peer Specialist | 730 Paige Ave Ne, Warren, OH 44483-4951 | 2019-12-19 |
1043852759 | Cody A Wright | Peer Specialist | 2307 Central Parkway Ave Se, Warren, OH 44484-5240 | 2019-10-14 |
1225638208 | Quiana Dodson | Peer Specialist | 552 N Park Ave, Warren, OH 44481-1117 | 2020-10-28 |
1174157507 | Angela Olivo | Peer Specialist | 2737 Youngstown Rd Se, Warren, OH 44484-5002 | 2020-02-25 |
1336782044 | Anna Lacy | Peer Specialist | 2737 Youngstown Rd Se, Warren, OH 44484-5002 | 2019-10-25 |
1619510526 | Jarreth Ackerman | Peer Specialist | 2737 Youngstown Rd Se, Warren, OH 44484-5002 | 2019-10-23 |
Find all providers in WARREN |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.