Healthcare Provider Details

I. General information

NPI: 1700300753
Provider Name (Legal Business Name): MARTINA JONES LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 05/10/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 MOORE ST
AKRON OH
44301-1453
US

IV. Provider business mailing address

274 WHITE POND DR
AKRON OH
44320-1118
US

V. Phone/Fax

Practice location:
  • Phone: 330-459-1506
  • Fax:
Mailing address:
  • Phone: 330-762-5425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2304796
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1700376
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: