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Individual

MS. JACQUELINE NASHELLE LOCKETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
35104 EUCLID AVE STE 306, WILLOUGHBY, OH 44094-4566
(216) 387-1759
(440) 571-5009
Mailing address
35104 EUCLID AVE STE 306, WILLOUGHBY, OH 44094-4566
(440) 571-5009
(440) 571-4850

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
S.1302602
OH
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
I.2102892
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0268275
OH
Enumeration date
02/16/2018
Last updated
10/27/2022
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