Provider Demographics
NPI:1528470424
Name:CORSER, JESSICA CHARLENE (LISW)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:CHARLENE
Last Name:CORSER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:CHARLENE
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:2837 SHERBROOKE RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3746
Mailing Address - Country:US
Mailing Address - Phone:917-623-4119
Mailing Address - Fax:
Practice Address - Street 1:508 N HAWLEY ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-4476
Practice Address - Country:US
Practice Address - Phone:419-255-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.14404301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical