Marissa Rose Ailing
Individual provider Active NPI Social Worker · Canton, OH
NPI 1154095560 · NPPES record last updated Aug 9, 2021
Key facts
- NPI
- 1154095560
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- S.2106583 (OH)
- Practice address
- 4942 Higbee Ave NW Ste Candd
Canton, OH 44718-2554 - Phone
- (330) 312-5993
- NPI assigned
- Aug 9, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.2106583 | OH | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.2106583 | OH | Yes |
Addresses
Primary practice location
4942 Higbee Ave NW Ste Candd
Canton, OH 44718-2554
Mailing address
4942 Higbee Ave NW Ste Candd
Canton, OH 44718-2554
Phone (330) 312-5993
Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.