Healthcare Provider Details

I. General information

NPI: 1174293682
Provider Name (Legal Business Name): CENTRAYA FORBES MSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2714 NEBRASKA AVE
TOLEDO OH
43607-3243
US

IV. Provider business mailing address

2714 NEBRASKA AVE
TOLEDO OH
43607-3243
US

V. Phone/Fax

Practice location:
  • Phone: 419-318-8847
  • Fax:
Mailing address:
  • Phone: 419-318-8847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2507255
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: