Healthcare Provider Details

I. General information

NPI: 1285157610
Provider Name (Legal Business Name): ALEXANDER G MAROSY MSW, LISW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1947 E MARKET ST
WARREN OH
44483-6644
US

IV. Provider business mailing address

8345 ANDERSON AVE NE
WARREN OH
44484-1537
US

V. Phone/Fax

Practice location:
  • Phone: 330-965-9999
  • Fax: 330-757-0000
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberI.1901979
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: