Healthcare Provider Details

I. General information

NPI: 1811704414
Provider Name (Legal Business Name): ANDREW SLUSS LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 W MARKET ST
LIMA OH
45805-2728
US

IV. Provider business mailing address

1235 W MARKET ST
LIMA OH
45805-2728
US

V. Phone/Fax

Practice location:
  • Phone: 567-289-6060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2107068
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: