Healthcare Provider Details

I. General information

NPI: 1871083063
Provider Name (Legal Business Name): JOAN LOZON COUNSELOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2018
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5461 SOUTHWYCK BLVD STE 2P
TOLEDO OH
43614-1553
US

IV. Provider business mailing address

5461 SOUTHWYCK BLVD STE 2P
TOLEDO OH
43614-1553
US

V. Phone/Fax

Practice location:
  • Phone: 419-913-8680
  • Fax: 419-913-8680
Mailing address:
  • Phone: 419-913-8680
  • Fax: 419-913-8680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2406274
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberLCDCII.081106
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: