Basic Information
| Provider Information | |||||||||
| NPI: | 1942770938 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEST | ||||||||
| FirstName: | JOSSELYN | ||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 680 PARK AVE W | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 449063706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195285993 | ||||||||
| FaxNumber: | 5605675486 | ||||||||
| Practice Location | |||||||||
| Address1: | 680 PARK AVE W | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 449063706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195285993 | ||||||||
| FaxNumber: | 5605675486 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/03/2018 | ||||||||
| LastUpdateDate: | 12/03/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | S.1450446 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.