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General NPI Number Information
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NPI Number | 1922245240
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Entity Type | Individual
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Provider Name | MARCIA A HESSELGRAVE LISW
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Gender | Female
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Dates
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Enumeration Date | 01/08/2009
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Last Update Date | 04/04/2018
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Provider Practice Location Address
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Address Line | 1426 CENTER RD.
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City | AVON
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State | OH
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Zip | 44011-1214
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Country | US
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Telephone | 844-468-5050
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Fax | 216-456-8128
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Provider Business Mailing Address
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Address Line | 10200 ALLIANCE RD SUITE 150
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City | CINCINNATI
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State | OH
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Zip | 45242-4754
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Country | US
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Telephone | 513-891-0650
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Fax | 513-891-2838
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | I6056
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1.0006056
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License Number State | OH
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