Jamila Ebony Provitt, LSW, BA, MSW

NPI #1700366614 in Warren, Ohio

Provider Information

NPI Number: 1700366614
Entity Type: Individual
Name: Jamila Ebony Provitt, LSW, BA, MSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker
Credential: LSW, BA, MSW
Enumeration Date: Aug 20, 2018
Last Updated: Feb 20, 2020

Practice Location

Address: 2671 YOUNGSTOWN RD SE
City: Warren
State: Ohio
ZIP Code: 44484-4404
Phone: (330) 469-9743

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X
Social Worker	104100000X	Primary

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