Provider Demographics
NPI:1942043195
Name:LEMASTER, JENNIFER LYN (CDCA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYN
Last Name:LEMASTER
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9956 JOHNNYCAKE RIDGE RD APT G4
Mailing Address - Street 2:
Mailing Address - City:CONCORD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-2144
Mailing Address - Country:US
Mailing Address - Phone:440-749-1845
Mailing Address - Fax:
Practice Address - Street 1:7301 RAVENNA RD
Practice Address - Street 2:
Practice Address - City:CONCORD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44077-8928
Practice Address - Country:US
Practice Address - Phone:440-205-2684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH188868101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)