Healthcare Provider Details

I. General information

NPI: 1699318584
Provider Name (Legal Business Name): CHRISTOPHER L WOZNIAK MSW, LSW, LICDC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2019
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 MEADOWSIDE LN
CENTERVILLE OH
45458-2816
US

IV. Provider business mailing address

2040 MEADOWSIDE LN
CENTERVILLE OH
45458-2816
US

V. Phone/Fax

Practice location:
  • Phone: 937-657-7486
  • Fax:
Mailing address:
  • Phone: 937-657-7486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLICDC.162294
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2207830
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: