Healthcare Provider Details

I. General information

NPI: 1104743947
Provider Name (Legal Business Name): ELAINAH R WEIBLE-WILLARD LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6545 W CENTRAL AVE
TOLEDO OH
43617-1089
US

IV. Provider business mailing address

6545 W CENTRAL AVE STE 202
TOLEDO OH
43617-1034
US

V. Phone/Fax

Practice location:
  • Phone: 567-343-3377
  • Fax:
Mailing address:
  • Phone: 419-932-0132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2614246
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: