Provider Demographics
NPI:1386846202
Name:CARROLL-THOMAS, JANA MARIE (MSW, LISW-S)
Entity type:Individual
Prefix:MRS
First Name:JANA
Middle Name:MARIE
Last Name:CARROLL-THOMAS
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-3779
Mailing Address - Country:US
Mailing Address - Phone:810-223-7293
Mailing Address - Fax:
Practice Address - Street 1:705 OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-3779
Practice Address - Country:US
Practice Address - Phone:810-223-7293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1800932-SUPV1041C0700X
MI68010891361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical