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General NPI Number Information
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NPI Number | 1083509871
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Entity Type | Individual
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Provider Name | CHRISTOPHER ALAN HARVEY LISW-S, LICDC-CS
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Gender | Male
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 553 E MANHATTAN BLVD
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City | TOLEDO
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State | OH
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Zip | 43608-1216
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Country | US
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Telephone | 419-219-7001
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Fax | 567-316-6462
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Provider Business Mailing Address
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Address Line | 1439 DEVONSHIRE ST
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2152
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Country | US
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Telephone | 419-250-1427
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.0700201-SUPV
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LICDC.031079
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801120206
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | CS.00001302
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License Number State | OH
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