Provider Demographics
NPI:1558512038
Name:REX, JEFFREY (AAS CDCA)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:REX
Suffix:
Gender:
Credentials:AAS CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4865
Mailing Address - Country:US
Mailing Address - Phone:419-229-2222
Mailing Address - Fax:419-229-2227
Practice Address - Street 1:205 W MARKET ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4865
Practice Address - Country:US
Practice Address - Phone:419-229-2222
Practice Address - Fax:419-229-2227
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH050373101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)