Healthcare Provider Details

I. General information

NPI: 1679375471
Provider Name (Legal Business Name): MARC HUFFMAN BSW, LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4653 E MAIN ST
WHITEHALL OH
43213-3298
US

IV. Provider business mailing address

4653 E MAIN ST
WHITEHALL OH
43213-3298
US

V. Phone/Fax

Practice location:
  • Phone: 800-329-5113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2512465
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: