Healthcare Provider Details

I. General information

NPI: 1376348250
Provider Name (Legal Business Name): MARA LAW LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 N LIMESTONE ST
SPRINGFIELD OH
45503-2676
US

IV. Provider business mailing address

2131 N LIMESTONE ST
SPRINGFIELD OH
45503-2676
US

V. Phone/Fax

Practice location:
  • Phone: 614-342-9784
  • Fax:
Mailing address:
  • Phone: 614-342-9784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1904313
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberS.1904313
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: