MEDICARE: MRS. MARIA JANE GARNER LSW,LICDC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	LICDC	OH
2	104100000X	Social Worker	S.1303473	OH

General Provider Information

NPI Number	:	1578972444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA JANE GARNER LSW,LICDC

Provider Business Mailing Address
First Line	:	1221 E WATERLOO RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44306-3805
Country	:	US
Telephone Number	:	234-208-4300
Fax Number	:	330-724-7662

Provider Business Practice Location Address
First Line	:	1221 E WATERLOO RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44306-3805
Country	:	US
Telephone Number	:	234-208-4300
Fax Number	:	330-724-7662

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2014
Last Update Date	:	04/09/2025

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