Healthcare Provider Details

I. General information

NPI: 1326618596
Provider Name (Legal Business Name): MADISON GLAVIC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2021
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 N CHESTNUT ST
RAVENNA OH
44266-2218
US

IV. Provider business mailing address

2359 SAVOY AVE
AKRON OH
44305-2151
US

V. Phone/Fax

Practice location:
  • Phone: 330-296-5552
  • Fax: 330-296-6126
Mailing address:
  • Phone: 330-727-2856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2506988
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: