Provider Demographics
NPI:1194429282
Name:JAMIE JOHANS CROSIER LLC
Entity type:Organization
Organization Name:JAMIE JOHANS CROSIER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSIER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW, BCD
Authorized Official - Phone:304-205-9327
Mailing Address - Street 1:403 BELL DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-2053
Mailing Address - Country:US
Mailing Address - Phone:304-205-9327
Mailing Address - Fax:
Practice Address - Street 1:403 BELL DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-2053
Practice Address - Country:US
Practice Address - Phone:304-205-9327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty