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NPI Code Detail

MEDICARE: MISS ALISA FORNEY

MEDICARE: MISS ALISA FORNEY
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
1101YA0400XAddiction (Substance Use Disorder) Counselor060613OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871007195
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ALISA FORNEY
Provider Business Mailing Address
First Line : PO BOX 8189
Second Line :
City : AKRON
State : OH
Zip : 44320-0189
Country : US
Telephone Number : 330-867-5400
Fax Number : 330-869-8263
Provider Business Practice Location Address
First Line : 1735 S HAWKINS AVE
Second Line :
City : AKRON
State : OH
Zip : 44320-3902
Country : US
Telephone Number : 330-867-5400
Fax Number : 330-869-8263
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2017
Last Update Date : 11/22/2017

Similar Medicare Providers

1225542285 — MR. DARRICK GRIFFIN CDCA, QMHSIII, OCPSA
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1881912269 — CAROL T. BOWES LPCC-S, LICDC-CS
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Practice Fax:
1932613247 — MISS MARY KENT LCDCIII, QMHS
Practice Location Address:
1735 S HAWKINS AVE
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44320-3902
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1649784935 — MR. CHARLES LEWIS CDCA, QMHS
Practice Location Address:
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Practice Fax: 330-869-8263

Directions to “ MISS ALISA FORNEY ” Practice Location

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