Individual
MRS. JANE MARIE CARSTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW, LICDC
Contact information
Practice address
246 NORTHLAND DR, MEDINA, OH 44256-3441
(330) 725-9195
Mailing address
246 NORTHLAND DR STE 200A, MEDINA, OH 44256-3440
(330) 725-9195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.161945
OH
1041C0700X
Clinical Social Worker
Primary
I.2102901-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0293619
—
OH
Enumeration date
11/20/2017
Last updated
11/06/2023
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