Provider Demographics
NPI:1285613661
Name:TRIPLETT, JUYNE VAUN (MSSA ACSW, LISW)
Entity type:Individual
Prefix:MS
First Name:JUYNE
Middle Name:VAUN
Last Name:TRIPLETT
Suffix:
Gender:F
Credentials:MSSA ACSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 SADDLER RD
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-1113
Mailing Address - Country:US
Mailing Address - Phone:440-871-4763
Mailing Address - Fax:
Practice Address - Street 1:24500 CENTER RIDGE RD
Practice Address - Street 2:BLDG. 4, SUITE 100
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5601
Practice Address - Country:US
Practice Address - Phone:440-899-1300
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI14091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHTRSW00632Medicare ID - Type Unspecified
OHAN9268841Medicare UPIN