Provider Demographics
NPI:1093694036
Name:WEBER, JODI LEE (LCSW)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:LEE
Last Name:WEBER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:248 MAIN ST APT 409
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-8166
Mailing Address - Country:US
Mailing Address - Phone:562-242-6561
Mailing Address - Fax:513-992-9101
Practice Address - Street 1:32730 WALKER RD STE J2
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-2235
Practice Address - Country:US
Practice Address - Phone:440-990-8822
Practice Address - Fax:513-992-9101
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-02
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1076581041C0700X
OHI.25071571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical