MEDICARE: STATE OF OHIO DEPARTMENT OF MENTAL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency		OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10408	OTHER	OH	MACSIS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104895176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STATE OF OHIO DEPARTMENT OF MENTAL HEALTH

Provider Business Mailing Address
First Line	:	30 E. BROAD ST
Second Line	:	11TH FLOOR - FISCAL ADMINISTRATION
City	:	COLUMBUS
State	:	OH
Zip	:	43215-3430
Country	:	US
Telephone Number	:	614-466-6583
Fax Number	:	614-644-5331

Provider Business Practice Location Address
First Line	:	157 W CEDAR ST
Second Line	:	SUITE B
City	:	AKRON
State	:	OH
Zip	:	44307-2564
Country	:	US
Telephone Number	:	330-467-7131
Fax Number	:	330-467-2420

Authorized Official
Title or Position	:	FISCAL MANAGER
Name	:	MS. TONYA MARIE FASONE
Credential	:
Telephone Number	:	614-466-9930

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	01/29/2008

Similar Medicare Providers

1518952191 — MRS. JODI L. LANCASTER MA CCCA
Practice Location Address:

157 W CEDAR ST , STE 106
AKRON, OH
44307-2564

Practice Phone: 330-376-1221
Practice Fax: 330-376-3953

1225068919 — DR. WALTER RICHARD RUF MD
Practice Location Address:

157 W CEDAR ST , #214
AKRON, OH
44307-2564

Practice Phone: 330-666-3238
Practice Fax: 330-668-3014

1992801377 — MS. CELESTE ELLEN LEARNER LISW
Practice Location Address:

157 W CEDAR ST , B-3
AKRON, OH
44307-2564

Practice Phone: 330-434-2062
Practice Fax: 330-434-0783

1336232685 — DR. GARY DOUGLAS OLSON D.D.S.
Practice Location Address:

157 W CEDAR ST , SUITE 206
AKRON, OH
44307-2564

Practice Phone: 330-253-8711
Practice Fax: 330-253-8711

1275616542 — EAR INC
Practice Location Address:

157 W CEDAR ST , STE 106
AKRON, OH
44307-2564

Practice Phone: 330-376-1221
Practice Fax: 330-376-3953

1720151814 — GARY W WALTZ MD
Practice Location Address:

157 W CEDAR ST , B-3
AKRON, OH
44307-2564

Practice Phone: 330-434-2062
Practice Fax: 330-434-0783

Directions to “STATE OF OHIO DEPARTMENT OF MENTAL HEALTH ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.