Healthcare Provider Details

I. General information

NPI: 1215583265
Provider Name (Legal Business Name): ANDREA DEMAR MHSA, MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3335 MEIJER DR STE 450
TOLEDO OH
43617-3122
US

IV. Provider business mailing address

7551 PEACHTREE LN
SYLVANIA OH
43560-4402
US

V. Phone/Fax

Practice location:
  • Phone: 28-109-9886
  • Fax:
Mailing address:
  • Phone: 419-973-8009
  • Fax: 419-930-4038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1903961
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: